Healthcare Provider Details

I. General information

NPI: 1124627740
Provider Name (Legal Business Name): ANGELICA MUNOZ PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2020
Last Update Date: 10/23/2020
Certification Date: 10/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 HUDSON YARDS FL 37
NEW YORK NY
10001-2160
US

IV. Provider business mailing address

8010 W 91ST ST
HICKORY HILLS IL
60457-1464
US

V. Phone/Fax

Practice location:
  • Phone: 844-782-4278
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number051287313
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: