Provider Demographics
NPI:1699374223
Name:CHA, SEOYEON (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SEOYEON
Middle Name:
Last Name:CHA
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 1:1555 N RAND RD
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60074-2919
Mailing Address - Country:US
Mailing Address - Phone:847-202-9441
Mailing Address - Fax:847-202-9458
Practice Address - Street 1:1555 N RAND RD
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60074-2919
Practice Address - Country:US
Practice Address - Phone:847-202-9441
Practice Address - Fax:847-202-9458
Is Sole Proprietor?:No
Enumeration Date:2020-10-24
Last Update Date:2020-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051293002183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist