Provider Demographics
NPI:1396029195
Name:SMELTER, VIOLETTA M (RPH)
Entity Type:Individual
Prefix:
First Name:VIOLETTA
Middle Name:M
Last Name:SMELTER
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 1:6403 N NEW ENGLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-1738
Mailing Address - Country:US
Mailing Address - Phone:773-763-5064
Mailing Address - Fax:
Practice Address - Street 1:9000 N GREENWOOD AVE
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-1408
Practice Address - Country:US
Practice Address - Phone:847-298-3050
Practice Address - Fax:847-298-2276
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-29
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051033259183500000X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy