Provider Demographics
NPI:1578611794
Name:ADAMS, DELICIA (PHARMD, BCGP)
Entity Type:Individual
Prefix:DR
First Name:DELICIA
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:PHARMD, BCGP
Other - Prefix:
Other - First Name:DELICIA
Other - Middle Name:
Other - Last Name:RUCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD, BCGP
Mailing Address - Street 1:401 WINGATE DR
Mailing Address - Street 2:
Mailing Address - City:CRETE
Mailing Address - State:IL
Mailing Address - Zip Code:60417-1962
Mailing Address - Country:US
Mailing Address - Phone:708-466-5122
Mailing Address - Fax:
Practice Address - Street 1:401 WINGATE DR
Practice Address - Street 2:
Practice Address - City:CRETE
Practice Address - State:IL
Practice Address - Zip Code:60417-1962
Practice Address - Country:US
Practice Address - Phone:708-466-5122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-287-4141835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric