Healthcare Provider Details

I. General information

NPI: 1861777815
Provider Name (Legal Business Name): ALLEN Y YEE I REGISTEREDPHARMACIST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2011
Last Update Date: 10/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 N GREENBAY ROAD
WAUKEGAN IL
60085
US

IV. Provider business mailing address

709 N GREENBAY ROAD
WAUKEGAN IL
60085
US

V. Phone/Fax

Practice location:
  • Phone: 847-662-8091
  • Fax: 847-662-8186
Mailing address:
  • Phone: 847-662-8091
  • Fax: 847-662-8186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051-034189
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: