Provider Demographics
NPI:1568747087
Name:SANCHEZ, TERESA M (RPH)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:M
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10445 LINDER AVE
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-4638
Mailing Address - Country:US
Mailing Address - Phone:773-430-5856
Mailing Address - Fax:
Practice Address - Street 1:7516 S CASS AVE
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:IL
Practice Address - Zip Code:60561-4496
Practice Address - Country:US
Practice Address - Phone:630-964-4242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-16
Last Update Date:2011-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051040437183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist