Healthcare Provider Details

I. General information

NPI: 1871686832
Provider Name (Legal Business Name): JENNIFER SHEEHAN LOCKER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER LYNN SHEEHAN

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

836 W WELLINGTON AVE
CHICAGO IL
60657-5147
US

IV. Provider business mailing address

1109 SHERMAN AVE
EVANSTON IL
60202-1335
US

V. Phone/Fax

Practice location:
  • Phone: 773-296-8379
  • Fax: 773-296-8021
Mailing address:
  • Phone: 410-486-4258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: