Provider Demographics
NPI:1215205430
Name:AGEH, DOLAPO (PHARM,D)
Entity Type:Individual
Prefix:DR
First Name:DOLAPO
Middle Name:
Last Name:AGEH
Suffix:
Gender:F
Credentials:PHARM,D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7410 N. CLARK STREET
Mailing Address - Street 2:WALGREENS PHARMACY
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626
Mailing Address - Country:US
Mailing Address - Phone:773-743-6784
Mailing Address - Fax:
Practice Address - Street 1:7410 N CLARK ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60626-1620
Practice Address - Country:US
Practice Address - Phone:773-743-6784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-02
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051286120183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist