Healthcare Provider Details

I. General information

NPI: 1003081506
Provider Name (Legal Business Name): GAIL S ITOKAZU PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2008
Last Update Date: 04/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 WEST HARRISON ST JOHN H STROGER JR HOSP OF COOK COUNTY
CHICAGO IL
60612-3714
US

IV. Provider business mailing address

1901 WEST HARRISON ST JOHN H STROGER JR HOSP OF COOK COUNTY
CHICAGO IL
60612-3714
US

V. Phone/Fax

Practice location:
  • Phone: 312-864-4586
  • Fax: 312-864-9496
Mailing address:
  • Phone: 312-864-4586
  • Fax: 312-864-9496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number051 037311
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: