Healthcare Provider Details

I. General information

NPI: 1487266342
Provider Name (Legal Business Name): CARLY MESSINGER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2020
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 N BROADWAY ST
CHICAGO IL
60657-3514
US

IV. Provider business mailing address

3030 N BROADWAY ST
CHICAGO IL
60657-7472
US

V. Phone/Fax

Practice location:
  • Phone: 773-327-3591
  • Fax: 773-327-3763
Mailing address:
  • Phone: 773-935-0713
  • Fax: 773-935-0733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number053100509
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051300509
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: