Healthcare Provider Details

I. General information

NPI: 1720699713
Provider Name (Legal Business Name): NORMAN HUANG PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2020
Last Update Date: 09/14/2020
Certification Date: 09/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 W CERMAK RD
CHICAGO IL
60616-1916
US

IV. Provider business mailing address

316 W CERMAK RD
CHICAGO IL
60616-1916
US

V. Phone/Fax

Practice location:
  • Phone: 312-791-0392
  • Fax:
Mailing address:
  • Phone: 773-656-6028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051.302395
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: