Provider Demographics
NPI:1689957961
Name:KAMIS, LEANNE M (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LEANNE
Middle Name:M
Last Name:KAMIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5429 N MILWAUKEE AVE
Mailing Address - Street 2:2A
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-1252
Mailing Address - Country:US
Mailing Address - Phone:773-286-0309
Mailing Address - Fax:773-286-2645
Practice Address - Street 1:4010 W LAWRENCE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630
Practice Address - Country:US
Practice Address - Phone:773-286-0309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051291757183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist