MEDICARE: AMI NENSEY

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
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	051303222	IL

General Provider Information

NPI Number	:	1326646738
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMI NENSEY

Provider Business Mailing Address
First Line	:	450 WARRENVILLE RD APT 404
Second Line	:
City	:	LISLE
State	:	IL
Zip	:	60532-1662
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	150 W 63RD ST
Second Line	:
City	:	WESTMONT
State	:	IL
Zip	:	60559-2614
Country	:	US
Telephone Number	:	630-964-4654
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/16/2020
Last Update Date	:	10/16/2020

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Directions to “ AMI NENSEY ” Practice Location

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