Provider Demographics
NPI:1376820399
Name:BREHM, LINDA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:
Last Name:BREHM
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 1:2717 N LEHMANN CT
Mailing Address - Street 2:UNIT 2
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-1600
Mailing Address - Country:US
Mailing Address - Phone:312-480-6143
Mailing Address - Fax:
Practice Address - Street 1:2717 N LEHMANN CT
Practice Address - Street 2:UNIT 2
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-1600
Practice Address - Country:US
Practice Address - Phone:312-480-6143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.287410183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist