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NPI Code Detail

MEDICARE: MISS AMY JOELLE NEDIC PHARM. D.

MEDICARE: MISS AMY JOELLE NEDIC PHARM. D.
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
1183500000XPharmacist051288489IL

General Provider Information

NPI Number : 1154602852
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS AMY JOELLE NEDIC PHARM. D.
Provider Business Mailing Address
First Line : 7401 W WINNEMAC AVE
Second Line :
City : HARWOOD HEIGHTS
State : IL
Zip : 60706-3426
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2828 N HARLEM AVE
Second Line :
City : ELMWOOD PARK
State : IL
Zip : 60707-1637
Country : US
Telephone Number : 708-583-0170
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2011
Last Update Date : 09/08/2011

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