Healthcare Provider Details

I. General information

NPI: 1770445470
Provider Name (Legal Business Name): NATALIE JEAN SPUDIC PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 OVERLOOK TER
MADISON WI
53705-2254
US

IV. Provider business mailing address

19425 TRENTON WAY
MOKENA IL
60448-7737
US

V. Phone/Fax

Practice location:
  • Phone: 888-478-8321
  • Fax:
Mailing address:
  • Phone: 708-465-2088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302416841
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: