Healthcare Provider Details

I. General information

NPI: 1013295872
Provider Name (Legal Business Name): SHARON SOOKHYUNG YIM PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2011
Last Update Date: 07/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2289 S MOUNT PROSPECT RD
DES PLAINES IL
60018-1810
US

IV. Provider business mailing address

117 WILDFLOWER CIR
BUFFALO GROVE IL
60089-1586
US

V. Phone/Fax

Practice location:
  • Phone: 847-227-1306
  • Fax: 847-768-1571
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number051.2877702
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: