Healthcare Provider Details

I. General information

NPI: 1982930020
Provider Name (Legal Business Name): HEATHER FIELDS PHARMD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2009
Last Update Date: 04/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9501 S KING DR DH 206
CHICAGO IL
60628-1501
US

IV. Provider business mailing address

9501 S KING DR DH 206
CHICAGO IL
60628-1501
US

V. Phone/Fax

Practice location:
  • Phone: 773-995-2500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051.293916
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: