Provider Demographics
NPI:1659563872
Name:TSE, CHING SANG (PHARMD, MBA)
Entity Type:Individual
Prefix:DR
First Name:CHING SANG
Middle Name:
Last Name:TSE
Suffix:
Gender:M
Credentials:PHARMD, MBA
Other - Prefix:DR
Other - First Name:TED
Other - Middle Name:C S
Other - Last Name:TSE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD, MBA
Mailing Address - Street 1:18604 CARPENTER ST
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-3536
Mailing Address - Country:US
Mailing Address - Phone:708-798-7050
Mailing Address - Fax:
Practice Address - Street 1:18604 CARPENTER ST
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-3536
Practice Address - Country:US
Practice Address - Phone:708-798-7050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-11
Last Update Date:2007-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X, 1835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric
No183500000XPharmacy Service ProvidersPharmacist