Provider Demographics
NPI:1043794381
Name:KUPINSKA, KLAUDIA (RPH)
Entity Type:Individual
Prefix:DR
First Name:KLAUDIA
Middle Name:
Last Name:KUPINSKA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3017 N MASON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-5139
Mailing Address - Country:US
Mailing Address - Phone:773-931-9022
Mailing Address - Fax:
Practice Address - Street 1:5600 W FULLERTON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60639-2305
Practice Address - Country:US
Practice Address - Phone:773-745-1640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-22
Last Update Date:2018-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-301387183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist