NPI 1215328489

Charolette Bodden, CPHT

Practitioner Pharmacy Technician Waukegan, IL

Practice location

Address: 3050 N Lewis Ave, Waukegan, IL 60087-2231
Phone: (847) 599-9079
Fax: (224) 399-4411

Registered specialties

Pharmacy Technician Primary

Pharmacy Service Providers Taxonomy 183700000X Licence 049173293 (IL)

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Registry record

NPI: 1215328489
Entity type: Individual
Sex (as registered): Female
NPI issued: 10 Feb 2015
Record last updated: 10 Feb 2015

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.