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General NPI Number Information
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NPI Number | 1215218151
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Entity Type | Individual
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Provider Name | SUSAN P BELLEH PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/06/2011
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Last Update Date | 09/06/2011
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Provider Practice Location Address
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Address Line | 650 DIXIE HWY
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City | CHICAGO HEIGHTS
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State | IL
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Zip | 60411-2143
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Country | US
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Telephone | 708-755-0058
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Fax | 708-755-6473
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Provider Business Mailing Address
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Address Line | 6753 PINE LAKE DR
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City | TINLEY PARK
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State | IL
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Zip | 60477-4935
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Country | US
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Telephone | 708-614-9030
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Fax | 708-614-9030
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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 | 051.291564
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License Number State | IL
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