MEDICARE: DR. TINA S EMMERSON 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
1	183500000X	Pharmacist		IL

General Provider Information

NPI Number	:	1508065475
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TINA S EMMERSON PHARMD

Provider Business Mailing Address
First Line	:	1860 S ARLINGTON HEIGHTS RD
Second Line	:
City	:	ARLINGTON HTS
State	:	IL
Zip	:	60005-3764
Country	:	US
Telephone Number	:	847-439-8892
Fax Number	:	847-439-7751

Provider Business Practice Location Address
First Line	:	1860 S ARLINGTON HEIGHTS RD
Second Line	:
City	:	ARLINGTON HTS
State	:	IL
Zip	:	60005-3764
Country	:	US
Telephone Number	:	847-439-8892
Fax Number	:	847-439-7751

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

Provider Enumeration Date	:	07/12/2007
Last Update Date	:	07/12/2007

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