Healthcare Provider Details

I. General information

NPI: 1154232817
Provider Name (Legal Business Name): ERICK F YUQUILIMA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S FAIRFIELD AVE
CHICAGO IL
60608-1782
US

IV. Provider business mailing address

4951 N AVERS AVE
CHICAGO IL
60625-6010
US

V. Phone/Fax

Practice location:
  • Phone: 773-257-4377
  • Fax:
Mailing address:
  • Phone: 872-325-7039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051.309144
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: