MEDICARE: PETER T MUI 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	1835P1200X	Pharmacotherapy Pharmacist	051-038949	IL

General Provider Information

NPI Number	:	1750530259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER T MUI PHARM.D.

Provider Business Mailing Address
First Line	:	1 N WAUKEGAN RD
Second Line	:	AP5 NE
City	:	NORTH CHICAGO
State	:	IL
Zip	:	60064-1802
Country	:	US
Telephone Number	:	847-938-8134
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 N WAUKEGAN RD
Second Line	:	AP 5 NE
City	:	NORTH CHICAGO
State	:	IL
Zip	:	60064-1802
Country	:	US
Telephone Number	:	847-938-8134
Fax Number	:

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

Provider Enumeration Date	:	09/09/2008
Last Update Date	:	10/17/2022

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