MEDICARE: MILIJANA VUKOBRAT 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
1	183500000X	Pharmacist	26024731A	IN

General Provider Information

NPI Number	:	1366795874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MILIJANA VUKOBRAT PHARM D

Provider Business Mailing Address
First Line	:	1717 E WEST RD
Second Line	:	T-0846
City	:	CALUMET CITY
State	:	IL
Zip	:	60409-5414
Country	:	US
Telephone Number	:	708-730-3101
Fax Number	:

Provider Business Practice Location Address
First Line	:	1717 E WEST RD
Second Line	:	T-0846
City	:	CALUMET CITY
State	:	IL
Zip	:	60409-5414
Country	:	US
Telephone Number	:	708-730-3101
Fax Number	:

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

Provider Enumeration Date	:	10/22/2012
Last Update Date	:	10/22/2012

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