MEDICARE: DR. TARANNUM F QURESHI 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	51289013	IL

General Provider Information

NPI Number	:	1770589319
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TARANNUM F QURESHI PHARMD

Provider Business Mailing Address
First Line	:	1309 N WELLS ST
Second Line	:	APT 1204
City	:	CHICAGO
State	:	IL
Zip	:	60610-8056
Country	:	US
Telephone Number	:	312-654-0287
Fax Number	:	773-868-8099

Provider Business Practice Location Address
First Line	:	2300 N CHILDRENS PLZ
Second Line	:	# 74
City	:	CHICAGO
State	:	IL
Zip	:	60614-3363
Country	:	US
Telephone Number	:	773-880-4566
Fax Number	:	773-868-8099

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

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	07/08/2007

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