Provider Demographics
NPI:1083784680
Name:CHEN, AMY (BS)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:BS
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:CHEN
Other - Last Name:PATRIARCA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BS
Mailing Address - Street 1:1539 INDEPENDENCE AVE
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-7723
Mailing Address - Country:US
Mailing Address - Phone:847-657-0278
Mailing Address - Fax:773-880-3254
Practice Address - Street 1:2300 N CHILDRENS PLZ
Practice Address - Street 2:OUTPATIENT PHARMACY BOX#74
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-3363
Practice Address - Country:US
Practice Address - Phone:773-880-4477
Practice Address - Fax:773-880-3254
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist