Provider Demographics
NPI:1437527355
Name:GUO, YA (PHARMD)
Entity Type:Individual
Prefix:
First Name:YA
Middle Name:
Last Name:GUO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KATY
Other - Middle Name:
Other - Last Name:GUO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:20 N ABERDEEN ST
Mailing Address - Street 2:APT 102
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-3042
Mailing Address - Country:US
Mailing Address - Phone:646-712-1070
Mailing Address - Fax:
Practice Address - Street 1:20 N ABERDEEN ST
Practice Address - Street 2:APT 102
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-3042
Practice Address - Country:US
Practice Address - Phone:646-712-1070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-09
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051299024183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist