Provider Demographics
NPI:1003103839
Name:TRAN, CHAFFEE (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHAFFEE
Middle Name:
Last Name:TRAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 E TOWNLINE RD
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1555
Mailing Address - Country:US
Mailing Address - Phone:847-680-0483
Mailing Address - Fax:847-371-3545
Practice Address - Street 1:313 E TOWNLINE RD
Practice Address - Street 2:
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1555
Practice Address - Country:US
Practice Address - Phone:847-680-0483
Practice Address - Fax:847-371-3545
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.294155183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist