Provider Demographics
NPI:1396015749
Name:ORTEGA-WIPACHIT, YOLI (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:YOLI
Middle Name:
Last Name:ORTEGA-WIPACHIT
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 1:1165 JOHN DR
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-5204
Mailing Address - Country:US
Mailing Address - Phone:847-519-3093
Mailing Address - Fax:
Practice Address - Street 1:2313 S MOUNT PROSPECT RD
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60018-1811
Practice Address - Country:US
Practice Address - Phone:847-635-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-03
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.289967183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist