MEDICARE: SEKOU M CHERIF PHARMACIST

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
1	1835G0303X	Geriatric Pharmacist	51040164	IL

General Provider Information

NPI Number	:	1083703110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEKOU M CHERIF PHARMACIST

Provider Business Mailing Address
First Line	:	820 S DAMEN
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612
Country	:	US
Telephone Number	:	312-569-7139
Fax Number	:

Provider Business Practice Location Address
First Line	:	1656 N NORMANDY AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60707-3922
Country	:	US
Telephone Number	:	312-569-7139
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	07/08/2007

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