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General NPI Number Information
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NPI Number | 1568803427
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Entity Type | Individual
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Provider Name | DR. EDNA CHIMA
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Gender | Female
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Dates
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Enumeration Date | 07/08/2013
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Last Update Date | 07/08/2013
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Provider Practice Location Address
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Address Line | 8001 BROADWAY STE 202
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City | MERRILLVILLE
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State | IN
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Zip | 46410-5546
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Country | US
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Telephone | 219-736-8067
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Fax | 219-736-8147
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Provider Business Mailing Address
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Address Line | 4240 189TH ST
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City | COUNTRY CLUB HILLS
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State | IL
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Zip | 60478-5610
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Country | US
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Telephone | 708-798-8612
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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 | 26024879A
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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 | 51.290949
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License Number State | IL
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