MEDICARE: JUDY TRUONG 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	051-294236	IL

General Provider Information

NPI Number	:	1598065104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDY TRUONG PHARMD

Provider Business Mailing Address
First Line	:	5235 N SHERIDAN RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-2512
Country	:	US
Telephone Number	:	773-728-7320
Fax Number	:

Provider Business Practice Location Address
First Line	:	5235 N SHERIDAN RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-2512
Country	:	US
Telephone Number	:	773-728-7320
Fax Number	:

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

Provider Enumeration Date	:	10/28/2010
Last Update Date	:	10/28/2010

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