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NPI Code Detail

MEDICARE: WAI KWAN TSE

MEDICARE: WAI KWAN TSE
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
1183500000XPharmacist051-294625IL

General Provider Information

NPI Number : 1093096992
Entity Type Code : Individual
Provider Name (Legal Business Name) : WAI KWAN TSE
Provider Business Mailing Address
First Line : 316 W CERMAK RD
Second Line :
City : CHICAGO
State : IL
Zip : 60616-1916
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 316 W CERMAK RD
Second Line :
City : CHICAGO
State : IL
Zip : 60616-1916
Country : US
Telephone Number : 312-791-0392
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2011
Last Update Date : 09/06/2011

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Directions to “ WAI KWAN TSE ” Practice Location

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