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NPI Code Detail

MEDICARE: STEPHANIE MOY PHARMD

MEDICARE: STEPHANIE MOY 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
1183500000XPharmacist051.294584IL

General Provider Information

NPI Number : 1477848109
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE MOY PHARMD
Provider Business Mailing Address
First Line : 2112 W PETERSON AVE
Second Line : T2079
City : CHICAGO
State : IL
Zip : 60659-4277
Country : US
Telephone Number : 773-761-3006
Fax Number : 773-761-3413
Provider Business Practice Location Address
First Line : 2112 W PETERSON AVE
Second Line : T2079
City : CHICAGO
State : IL
Zip : 60659-4277
Country : US
Telephone Number : 773-761-3006
Fax Number : 773-761-3413
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2011
Last Update Date : 06/10/2011

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Directions to “ STEPHANIE MOY PHARMD” Practice Location

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