MEDICARE: JANIE GREENBERG BS PHARMACY

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	051035034	IL

General Provider Information

NPI Number	:	1245512524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANIE GREENBERG BS PHARMACY

Provider Business Mailing Address
First Line	:	1 W SUPERIOR ST
Second Line	:	1304
City	:	CHICAGO
State	:	IL
Zip	:	60654-8803
Country	:	US
Telephone Number	:	480-221-5622
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 W SUPERIOR ST
Second Line	:	1304
City	:	CHICAGO
State	:	IL
Zip	:	60654-8803
Country	:	US
Telephone Number	:	480-221-5622
Fax Number	:

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

Provider Enumeration Date	:	09/13/2011
Last Update Date	:	09/13/2011

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