Healthcare Provider Details

I. General information

NPI: 1578272100
Provider Name (Legal Business Name): SAVANNAH J WILLS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/22/2022
Last Update Date: 11/23/2022
Certification Date: 11/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 PFINGSTEN RD
GLENVIEW IL
60026-1301
US

IV. Provider business mailing address

4250 W LAKE AVE APT A209
GLENVIEW IL
60026-7412
US

V. Phone/Fax

Practice location:
  • Phone: 847-657-1785
  • Fax:
Mailing address:
  • Phone: 770-561-0859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051.305233
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: