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NPI Code Detail

MEDICARE: DR. REBECCA SOULIOTIS PHARMD

MEDICARE: DR. REBECCA SOULIOTIS 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
1183500000XPharmacist051288136IL
2183500000XPharmacist288136IL

General Provider Information

NPI Number : 1407499460
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. REBECCA SOULIOTIS PHARMD
Provider Business Mailing Address
First Line : 4700 135TH ST
Second Line :
City : CRESTWOOD
State : IL
Zip : 60418-1405
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4700 135TH ST
Second Line :
City : CRESTWOOD
State : IL
Zip : 60418-1405
Country : US
Telephone Number : 708-489-6476
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2019
Last Update Date : 10/22/2019

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Directions to “ DR. REBECCA SOULIOTIS PHARMD” Practice Location

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