Provider Demographics
NPI:1578800835
Name:GREENFIELD, PAMELA (PARMD)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:GREENFIELD
Suffix:
Gender:F
Credentials:PARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1685 LAKE ELEANOR DR
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-2052
Mailing Address - Country:US
Mailing Address - Phone:847-236-1072
Mailing Address - Fax:
Practice Address - Street 1:2099 SKOKIE VALLEY ROAD
Practice Address - Street 2:TARGET PHARMACY
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035
Practice Address - Country:US
Practice Address - Phone:847-266-8022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051289343183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist