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General NPI Number Information
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NPI Number | 1073631768
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Entity Type | Individual
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Provider Name | ANNE MARNERIS RPH
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Gender | Female
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8700 S CICERO AVE DOMINICK'S PHARMACY
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City | OAK LAWN
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State | IL
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Zip | 60453-1372
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Country | US
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Telephone | 708-422-0471
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Fax | 708-424-7058
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Provider Business Mailing Address
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Address Line | 10612 S CLAREMONT AVE
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City | CHICAGO
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State | IL
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Zip | 60643-3102
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Country | US
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Telephone | 773-445-3503
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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 |
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License Number State | IL
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