NPI 1063846335

Chaunta Nicole Willis, CPHT

Practitioner Pharmacy Technician Chicago, IL

Practice location

Address: 3753 S Cottage Grove Ave, Chicago, IL 60653-1407
Phone: (773) 451-0712
Fax: (773) 451-0714

Registered specialties

Pharmacy Technician Primary

Pharmacy Service Providers Taxonomy 183700000X Licence 049168746 (IL)

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Registry record

NPI: 1063846335
Entity type: Individual
Sex (as registered): Female
NPI issued: 22 Aug 2013
Record last updated: 22 Aug 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.