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NPI Code Detail

MEDICARE: AMANDA MARIE COMBES PHARMD.

MEDICARE: AMANDA MARIE COMBES 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
1183500000XPharmacist051291823IL

General Provider Information

NPI Number : 1609160969
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA MARIE COMBES PHARMD.
Provider Business Mailing Address
First Line : 4466 N BROADWAY ST
Second Line :
City : CHICAGO
State : IL
Zip : 60640-5660
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4466 N BROADWAY ST
Second Line :
City : CHICAGO
State : IL
Zip : 60640-5660
Country : US
Telephone Number : 773-596-2377
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2011
Last Update Date : 06/04/2011

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Directions to “ AMANDA MARIE COMBES PHARMD.” Practice Location

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