Provider Demographics
NPI:1003416439
Name:VENKETRAMEN, DENISE (DOCTOR OF PHARMACY)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:VENKETRAMEN
Suffix:
Gender:F
Credentials:DOCTOR OF PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:939 W MADISON ST APT 310
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-2656
Mailing Address - Country:US
Mailing Address - Phone:312-925-7532
Mailing Address - Fax:
Practice Address - Street 1:939 W MADISON ST APT 310
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-2656
Practice Address - Country:US
Practice Address - Phone:312-925-7532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051292437183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist