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General NPI Number Information
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NPI Number | 1336291863
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Entity Type | Individual
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Provider Name | SCOTT V WEHMAN PHARMD
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Gender | Male
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 10/26/2011
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Provider Practice Location Address
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Address Line | 836 W WELLINGTON AVE ADVOCATE ILLINOIS MASONIC MEDICAL CENTER
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City | CHICAGO
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State | IL
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Zip | 60657-5147
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Country | US
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Telephone | 773-296-5040
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Fax |
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Provider Business Mailing Address
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Address Line | 434 LENOX ST
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City | OAK PARK
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State | IL
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Zip | 60302-1340
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Country | US
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Telephone | 708-848-4215
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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 | 051.287775
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License Number State | IL
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