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General NPI Number Information
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NPI Number | 1568156891
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Entity Type | Individual
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Provider Name | RODNITA SAMUELS PHARMD
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Gender | Female
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Dates
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Enumeration Date | 06/08/2023
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Last Update Date | 06/08/2023
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Provider Practice Location Address
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Address Line | 111 DEER LAKE RD STE 130
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City | DEERFIELD
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State | IL
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Zip | 60015-4978
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Country | US
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Telephone | 855-422-7744
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Fax | 888-810-2014
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Provider Business Mailing Address
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Address Line | 425 E 48TH ST
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City | CHICAGO
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State | IL
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Zip | 60615-1401
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Country | US
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Telephone | 773-490-7906
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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 | 26026869A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 051301106
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License Number State | IL
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