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General NPI Number Information
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NPI Number | 1043883838
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Entity Type | Individual
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Provider Name | EMLO BEBO PHARMD
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Gender | Female
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Dates
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Enumeration Date | 07/20/2021
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Last Update Date | 08/02/2021
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Provider Practice Location Address
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Address Line | 1100 S RANDALL RD
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City | ELGIN
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State | IL
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Zip | 60123-4109
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Country | US
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Telephone | 847-468-9696
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Fax | 847-468-5077
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Provider Business Mailing Address
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Address Line | 1100 S RANDALL RD
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City | ELGIN
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State | IL
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Zip | 60123-4109
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Country | US
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Telephone | 847-468-9696
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Fax | 847-468-8077
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 051304032
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License Number State | IL
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