Provider Demographics
NPI:1689956385
Name:SESSA, PIETRO F
Entity Type:Individual
Prefix:
First Name:PIETRO
Middle Name:F
Last Name:SESSA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:PETER
Other - Middle Name:F
Other - Last Name:SESSA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4837 N LEONARD DR
Mailing Address - Street 2:
Mailing Address - City:NORRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60706-2938
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4343 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-1817
Practice Address - Country:US
Practice Address - Phone:773-427-9456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-19
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051288381183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist