Provider Demographics
NPI:1083984009
Name:UHLEAN, TERI D (PHARMD)
Entity Type:Individual
Prefix:
First Name:TERI
Middle Name:D
Last Name:UHLEAN
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 1:17712 CLIFTON CT
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60487-8495
Mailing Address - Country:US
Mailing Address - Phone:708-614-9168
Mailing Address - Fax:
Practice Address - Street 1:17712 CLIFTON CT
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60487-8495
Practice Address - Country:US
Practice Address - Phone:708-614-9168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-039035183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist