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NPI Code Detail

MEDICARE: MRS. KATIE STEPHENSON PHARMD

MEDICARE: MRS. KATIE STEPHENSON PHARMD
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
1183500000XPharmacist051295467IL

General Provider Information

NPI Number : 1669759445
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATIE STEPHENSON PHARMD
Provider Business Mailing Address
First Line : 50 E NORTH AVE
Second Line : T-0957
City : VILLA PARK
State : IL
Zip : 60181-1244
Country : US
Telephone Number : 630-833-7461
Fax Number : 630-833-7461
Provider Business Practice Location Address
First Line : 50 E NORTH AVE
Second Line : T-0957
City : VILLA PARK
State : IL
Zip : 60181-1244
Country : US
Telephone Number : 630-833-7461
Fax Number : 630-833-7461
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2011
Last Update Date : 11/08/2011

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