MEDICARE: TINA VENNOOKKARAN

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	41794	TX

General Provider Information

NPI Number	:	1356621965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TINA VENNOOKKARAN

Provider Business Mailing Address
First Line	:	4720 N MARINE DR
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-5120
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4720 N MARINE DR
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-5120
Country	:	US
Telephone Number	:	773-769-1315
Fax Number	:

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

Provider Enumeration Date	:	08/26/2011
Last Update Date	:	08/26/2011

Similar Medicare Providers

1003821315 — WALGREEN CO
Practice Location Address:

4720 N MARINE DR
CHICAGO, IL
60640-5120

Practice Phone: 773-769-1315
Practice Fax:

1033348206 — FAYCOR N A INC
Practice Location Address:

4700 N MARINE DR , 5TH FLOOR
CHICAGO, IL
60640-5120

Practice Phone: 847-291-9058
Practice Fax: 847-291-9095

1316227929 — MICHELLE LEE PHARM.D.
Practice Location Address:

4720 N MARINE DR
CHICAGO, IL
60640-5120

Practice Phone: 773-769-1315
Practice Fax: 773-769-3368

1972847820 — SOUTH-EAST ASIA CENTER
Practice Location Address:

5120 N BROADWAY ST
CHICAGO, IL
60640-3004

Practice Phone: 773-989-6927
Practice Fax: 888-831-5471

1437506730 — HOME INSTEAD SENIOR CARE
Practice Location Address:

4736 N MARINE DR
CHICAGO, IL
60640-5120

Practice Phone: 773-784-4024
Practice Fax: 773-334-9867

1598276370 — MR. DAVIS MARIO POHLY RPH
Practice Location Address:

4720 N MARINE DR
CHICAGO, IL
60640-5120

Practice Phone: 773-769-1315
Practice Fax:

Directions to “ TINA VENNOOKKARAN ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.