MEDICARE: MRS. MILA L ALBERT 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	183500000X	Pharmacist	051-288677	IL

General Provider Information

NPI Number	:	1972582179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MILA L ALBERT PHARM.D

Provider Business Mailing Address
First Line	:	820 S DAMEN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-3728
Country	:	US
Telephone Number	:	312-569-7174
Fax Number	:	312-569-8122

Provider Business Practice Location Address
First Line	:	820 S DAMEN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-3728
Country	:	US
Telephone Number	:	312-569-7174
Fax Number	:	312-569-8122

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

Provider Enumeration Date	:	01/16/2006
Last Update Date	:	05/19/2008

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