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NPI Code Detail

MEDICARE: DR. BRIGHT YAO AWUTEY PHARMD

MEDICARE: DR. BRIGHT YAO AWUTEY 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
1183500000XPharmacist051304321IL

General Provider Information

NPI Number : 1396417192
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRIGHT YAO AWUTEY PHARMD
Provider Business Mailing Address
First Line : 2030 S STATE ST APT 1703
Second Line :
City : CHICAGO
State : IL
Zip : 60616-1555
Country : US
Telephone Number : 312-213-4764
Fax Number :
Provider Business Practice Location Address
First Line : 5222 W MADISON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60644-4141
Country : US
Telephone Number : 773-287-0380
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2021
Last Update Date : 09/30/2021

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