Provider Demographics
NPI:1083832893
Name:CIOLKO, CHRISTINE MARIA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:MARIA
Last Name:CIOLKO
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 1:1149 HARLAN CT
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-3854
Mailing Address - Country:US
Mailing Address - Phone:847-295-2362
Mailing Address - Fax:
Practice Address - Street 1:1149 HARLAN CT
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-3854
Practice Address - Country:US
Practice Address - Phone:847-295-2362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist