Provider Demographics
NPI:1548385875
Name:CATALANO, MICHELLE JACQUELINE (PHARMD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:JACQUELINE
Last Name:CATALANO
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 1:747 N WABASH AVE APT 804
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2531
Mailing Address - Country:US
Mailing Address - Phone:847-609-9407
Mailing Address - Fax:
Practice Address - Street 1:424 W DIVISION ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-1727
Practice Address - Country:US
Practice Address - Phone:312-274-1706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist