MEDICARE: KATARZYNA LASCH

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	051.299047	IL

General Provider Information

NPI Number	:	1619324415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATARZYNA LASCH

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

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

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

Provider Enumeration Date	:	05/21/2016
Last Update Date	:	05/21/2016

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