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NPI Code Detail

MEDICARE: JENNY M CHEUNG PHARM D

MEDICARE: JENNY M CHEUNG 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
1183500000XPharmacist051291361IL

General Provider Information

NPI Number : 1699055244
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNY M CHEUNG PHARM D
Provider Business Mailing Address
First Line : 1620 S MICHIGAN AVE
Second Line : UNIT 803
City : CHICAGO
State : IL
Zip : 60616-1281
Country : US
Telephone Number : 773-732-4323
Fax Number :
Provider Business Practice Location Address
First Line : 3019 W PETERSON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60659-3726
Country : US
Telephone Number : 773-728-6254
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2011
Last Update Date : 08/26/2011

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