Provider Demographics
NPI:1699379248
Name:MCDERMOTT, ALYSON (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALYSON
Middle Name:
Last Name:MCDERMOTT
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 1:1217 N POINTE DR
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-1374
Mailing Address - Country:US
Mailing Address - Phone:847-975-0145
Mailing Address - Fax:
Practice Address - Street 1:6901 N HAMLIN AVE
Practice Address - Street 2:
Practice Address - City:LINCOLNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60712-2538
Practice Address - Country:US
Practice Address - Phone:847-677-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.291916183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist