MEDICARE: MIYEON PRESKY 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
1	183500000X	Pharmacist	051.298706	IL

General Provider Information

NPI Number	:	1326419839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIYEON PRESKY PHARMD

Provider Business Mailing Address
First Line	:	500 S CLINTON ST APT 911
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60607-4331
Country	:	US
Telephone Number	:	845-750-3349
Fax Number	:

Provider Business Practice Location Address
First Line	:	2500 N CLARK ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-1712
Country	:	US
Telephone Number	:	773-929-7488
Fax Number	:

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

Provider Enumeration Date	:	10/09/2015
Last Update Date	:	10/09/2015

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Directions to “ MIYEON PRESKY PHARMD” Practice Location

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