Provider Demographics
NPI:1700398310
Name:ILYUSHENKO, YULIYA K (PHARMD)
Entity Type:Individual
Prefix:
First Name:YULIYA
Middle Name:K
Last Name:ILYUSHENKO
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 1:20622 N CAVE CREEK RD STE C-121
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85024-4452
Mailing Address - Country:US
Mailing Address - Phone:480-351-8278
Mailing Address - Fax:480-351-8277
Practice Address - Street 1:20622 N CAVE CREEK RD STE C-121
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85024
Practice Address - Country:US
Practice Address - Phone:480-351-8278
Practice Address - Fax:480-351-8277
Is Sole Proprietor?:No
Enumeration Date:2017-11-04
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS0226811835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care