Healthcare Provider Details

I. General information

NPI: 1720811391
Provider Name (Legal Business Name): SILVANA BEBAWY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2024
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W CENTRAL RD
ARLINGTON HEIGHTS IL
60005-2349
US

IV. Provider business mailing address

118 AQUARIUS
IRVINE CA
92618-1338
US

V. Phone/Fax

Practice location:
  • Phone: 312-399-0565
  • Fax:
Mailing address:
  • Phone: 312-399-0565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number89611
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: