MEDICARE: MARIANNE JULIE MIGLIORISI R.PH C.G.P

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	1835P1200X	Pharmacotherapy Pharmacist		IL

General Provider Information

NPI Number	:	1548260953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIANNE JULIE MIGLIORISI R.PH C.G.P

Provider Business Mailing Address
First Line	:	901 W LYNNWOOD AVE
Second Line	:
City	:	ARLINGTON HTS
State	:	IL
Zip	:	60004-3766
Country	:	US
Telephone Number	:	847-255-2554
Fax Number	:

Provider Business Practice Location Address
First Line	:	901 W LYNNWOOD AVE
Second Line	:
City	:	ARLINGTON HTS
State	:	IL
Zip	:	60004-3766
Country	:	US
Telephone Number	:	847-255-2554
Fax Number	:

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

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	07/08/2007

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