Healthcare Provider Details

I. General information

NPI: 1205678265
Provider Name (Legal Business Name): EMILY ELIZABETH VIGLIELMO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2024
Last Update Date: 06/11/2024
Certification Date: 06/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1N141 WOODS AVE
CAROL STREAM IL
60188-2268
US

IV. Provider business mailing address

1N141 WOODS AVE
CAROL STREAM IL
60188-2268
US

V. Phone/Fax

Practice location:
  • Phone: 630-921-1160
  • Fax:
Mailing address:
  • Phone: 630-921-1160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051.296645
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: