Provider Demographics
NPI:1518052059
Name:QUILLIAN, CHRISTINA W (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:W
Last Name:QUILLIAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2754 N. HAMPDEN COURT 1305
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-8345
Mailing Address - Country:US
Mailing Address - Phone:708-202-7240
Mailing Address - Fax:
Practice Address - Street 1:FIFTH AVENUE AND ROOSEVELT ROAD
Practice Address - Street 2:PHARMACY PRACTICE 119K
Practice Address - City:HINES
Practice Address - State:IL
Practice Address - Zip Code:60141-1234
Practice Address - Country:US
Practice Address - Phone:708-202-7240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0510402681835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy