Healthcare Provider Details

I. General information

NPI: 1659658755
Provider Name (Legal Business Name): AKUA S BAMFO-AGYEI PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2011
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7111 S WESTERN AVE
CHICAGO IL
60636-3614
US

IV. Provider business mailing address

7111 S WESTERN AVE
CHICAGO IL
60636-3614
US

V. Phone/Fax

Practice location:
  • Phone: 630-865-6473
  • Fax:
Mailing address:
  • Phone: 630-865-6473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number051288514
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: