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General NPI Number Information
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NPI Number | 1205189214
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Entity Type | Individual
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Provider Name | SAE HWANG RPH
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Gender | Female
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Dates
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Enumeration Date | 10/16/2012
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Last Update Date | 10/16/2012
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Provider Practice Location Address
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Address Line | 892 N. WESTERN AVE
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City | LAKE FOREST
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State | IL
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Zip | 60045
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Country | US
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Telephone | 847-735-1039
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Fax | 847-735-0378
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Provider Business Mailing Address
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Address Line | 3565 KRENN AVE
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City | HIGHLAND PARK
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State | IL
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Zip | 60035
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Country | US
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Telephone | 847-681-8773
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Fax | 847-681-8773
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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 | 051.286410
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License Number State | IL
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