MEDICARE: MS. VANESSA DION KING-FRANKLIN RPH, PHARM.D

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	051-040528	IL

General Provider Information

NPI Number	:	1548546021
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VANESSA DION KING-FRANKLIN RPH, PHARM.D

Provider Business Mailing Address
First Line	:	70 ROSEWOOD LN
Second Line	:
City	:	CHICAGO HEIGHTS
State	:	IL
Zip	:	60411-1150
Country	:	US
Telephone Number	:	773-991-2734
Fax Number	:	708-755-6473

Provider Business Practice Location Address
First Line	:	650 DIXIE HWY
Second Line	:
City	:	CHICAGO HEIGHTS
State	:	IL
Zip	:	60411-2143
Country	:	US
Telephone Number	:	708-755-0058
Fax Number	:	708-755-6473

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

Provider Enumeration Date	:	10/27/2011
Last Update Date	:	10/27/2011

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