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General NPI Number Information
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NPI Number | 1063681658
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Entity Type | Individual
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Provider Name | TASHA LENETTE WILLIAMS PHARMD
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Gender | Female
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Dates
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Enumeration Date | 02/27/2008
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Last Update Date | 04/27/2011
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Provider Practice Location Address
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Address Line | 1468 ELMHURST RD
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City | ELK GROVE VILLAGE
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State | IL
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Zip | 60007-6417
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Country | US
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Telephone | 773-491-8444
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Fax |
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Provider Business Mailing Address
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Address Line | 7115 W. NORTH AVENUE #200
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City | OAK PARK
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State | IL
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Zip | 60302
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Country | US
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Telephone | 773-491-8444
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Fax |
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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 | 051-289413
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License Number State | IL
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