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General NPI Number Information
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NPI Number | 1366723983
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Entity Type | Individual
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Provider Name | ELIZABETH ANN SERSCH PHARM D
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Gender | Female
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Dates
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Enumeration Date | 09/09/2011
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Last Update Date | 09/09/2011
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Provider Practice Location Address
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Address Line | 3153 W IRVING PARK RD
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City | CHICAGO
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State | IL
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Zip | 60618-3409
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Country | US
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Telephone | 773-588-9196
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Fax | 773-588-9406
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Provider Business Mailing Address
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Address Line | 1903 W CHICAGO AVE UNIT 3
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City | CHICAGO
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State | IL
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Zip | 60622-7862
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Country | US
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Telephone | 717-512-6783
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Fax | 773-588-9406
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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 | 051291717
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License Number State | IL
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