Healthcare Provider Details

I. General information

NPI: 1447294012
Provider Name (Legal Business Name): ANNETTE N PELLEGRINO PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 09/06/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 S WOOD ST M/C 886
CHICAGO IL
60612-7229
US

IV. Provider business mailing address

833 S WOOD ST M/C 886
CHICAGO IL
60612-7229
US

V. Phone/Fax

Practice location:
  • Phone: 312-996-6110
  • Fax:
Mailing address:
  • Phone: 312-996-6110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: