=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861516346
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANDREW WILLIAM TSELEPIS RPH
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/19/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1555 W. NORTH AURORA RD.
-----------------------------------------------------
City | NAPERVILLE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60563
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-637-3846
-----------------------------------------------------
Fax | 630-637-3845
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2608 ZURICH CT
-----------------------------------------------------
City | WOODRIDGE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60517-4506
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-637-3846
-----------------------------------------------------
Fax | 630-637-3845
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------