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NPI Code Detail

MEDICARE: VICTORIA POHLID

MEDICARE:   VICTORIA  POHLID
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist051297986IL

General Provider Information

NPI Number : 1093118200
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA POHLID
Provider Business Mailing Address
First Line : 360 W ILLINOIS ST APT 4G
Second Line :
City : CHICAGO
State : IL
Zip : 60654-5253
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3320 W FULLERTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-2514
Country : US
Telephone Number : 773-252-8346
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2014
Last Update Date : 10/01/2014

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Directions to “ VICTORIA POHLID ” Practice Location

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