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General NPI Number Information
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NPI Number | 1457653578
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Entity Type | Individual
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Provider Name | BEVERLY ANN FUGIEL RPH
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Gender | Female
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Dates
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Enumeration Date | 11/22/2010
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Last Update Date | 11/22/2010
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Provider Practice Location Address
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Address Line | 2520 N NARRAGANSETT AVE
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City | CHICAGO
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State | IL
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Zip | 60639-1041
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Country | US
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Telephone | 773-637-1819
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Fax | 773-637-1875
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Provider Business Mailing Address
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Address Line | 7342 N OLCOTT AVE
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City | CHICAGO
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State | IL
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Zip | 60631-4317
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Country | US
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Telephone | 773-763-0471
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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 | 051-035592
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License Number State | IL
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