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NPI Code Detail

MEDICARE: BETTY N INGENTE PHARMACIST

MEDICARE: BETTY N INGENTE PHARMACIST
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
1183500000XPharmacistIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407970379
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETTY N INGENTE PHARMACIST
Provider Business Mailing Address
First Line : 3153 W FULLERTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-2809
Country : US
Telephone Number : 773-278-6604
Fax Number : 773-395-4633
Provider Business Practice Location Address
First Line : 3153 W FULLERTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-2809
Country : US
Telephone Number : 773-278-6604
Fax Number : 773-395-4633
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2007
Last Update Date : 07/08/2007

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Directions to “ BETTY N INGENTE PHARMACIST” Practice Location

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