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NPI Code Detail

MEDICARE: DR. TASHA LENETTE WILLIAMS PHARMD

MEDICARE:  DR. TASHA LENETTE WILLIAMS  PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist051-289413IL

General Provider Information

NPI Number : 1063681658
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TASHA LENETTE WILLIAMS PHARMD
Provider Business Mailing Address
First Line : 7115 W. NORTH AVENUE
Second Line : #200
City : OAK PARK
State : IL
Zip : 60302
Country : US
Telephone Number : 773-491-8444
Fax Number :
Provider Business Practice Location Address
First Line : 1468 ELMHURST RD
Second Line :
City : ELK GROVE VILLAGE
State : IL
Zip : 60007-6417
Country : US
Telephone Number : 773-491-8444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2008
Last Update Date : 04/27/2011

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