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General NPI Number Information
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NPI Number | 1912508300
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Entity Type | Individual
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Provider Name | KARON HAMPTON
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Gender | Female
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Dates
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Enumeration Date | 11/03/2020
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Last Update Date | 11/03/2020
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Provider Practice Location Address
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Address Line | 4650 W NORTH AVE
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City | CHICAGO
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State | IL
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Zip | 60639-4611
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Country | US
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Telephone | 773-252-7769
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Fax |
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Provider Business Mailing Address
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Address Line | 1231 N KENILWORTH AVE
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City | OAK PARK
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State | IL
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Zip | 60302-1217
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Country | US
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Telephone | 708-280-4935
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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 | 051.039207
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License Number State | IL
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