Healthcare Provider Details

I. General information

NPI: 1356288294
Provider Name (Legal Business Name): MELISSA WASHKOWIAK PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 E CHICAGO AVE # 74
CHICAGO IL
60611-2991
US

IV. Provider business mailing address

3504 N SOUTHPORT AVE APT 2S
CHICAGO IL
60657-3986
US

V. Phone/Fax

Practice location:
  • Phone: 312-227-4151
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0200X
TaxonomyPediatric Pharmacist
License Number051286808
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: