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General NPI Number Information
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NPI Number | 1275059347
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Entity Type | Individual
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Provider Name | CONNIE HON-NING YAN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/20/2017
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Last Update Date | 08/20/2017
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Provider Practice Location Address
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Address Line | 316 W CERMAK RD
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City | CHICAGO
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State | IL
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Zip | 60616-1916
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Country | US
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Telephone | 312-791-0392
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Fax |
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Provider Business Mailing Address
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Address Line | 2812 S SHIELDS AVE
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City | CHICAGO
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State | IL
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Zip | 60616-2626
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Country | US
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Telephone |
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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 | 049.189542
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License Number State | IL
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