Provider Demographics
NPI:1720369762
Name:TAMULYNAS, BIRUTE (PHARMD)
Entity Type:Individual
Prefix:
First Name:BIRUTE
Middle Name:
Last Name:TAMULYNAS
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 1:1355 E 55TH PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60637-1709
Mailing Address - Country:US
Mailing Address - Phone:773-324-0292
Mailing Address - Fax:
Practice Address - Street 1:1554 E 55TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-5550
Practice Address - Country:US
Practice Address - Phone:773-667-1177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-05
Last Update Date:2011-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051038368183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist