Provider Demographics
NPI:1457636011
Name:REED, CHARA A (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:CHARA
Middle Name:A
Last Name:REED
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 1:688 AMERSALE DR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-2264
Mailing Address - Country:US
Mailing Address - Phone:630-961-5015
Mailing Address - Fax:630-961-5057
Practice Address - Street 1:688 AMERSALE DR
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-2264
Practice Address - Country:US
Practice Address - Phone:630-961-5015
Practice Address - Fax:630-961-5057
Is Sole Proprietor?:No
Enumeration Date:2011-10-14
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-289712183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL361924025062Medicaid