Provider Demographics
NPI:1427405943
Name:SEFCIK, ANMARIE
Entity Type:Individual
Prefix:
First Name:ANMARIE
Middle Name:
Last Name:SEFCIK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2038 PRAIRIE ST
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-3578
Mailing Address - Country:US
Mailing Address - Phone:630-377-1655
Mailing Address - Fax:630-377-2622
Practice Address - Street 1:2038 PRAIRIE ST
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-3578
Practice Address - Country:US
Practice Address - Phone:630-377-1655
Practice Address - Fax:630-377-2622
Is Sole Proprietor?:No
Enumeration Date:2016-05-16
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL054.006975183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist