Provider Demographics
NPI:1851727176
Name:ROSADO, DELCINA A (PHARMACIST)
Entity Type:Individual
Prefix:MRS
First Name:DELCINA
Middle Name:A
Last Name:ROSADO
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:MRS
Other - First Name:DELCINA
Other - Middle Name:A
Other - Last Name:SIMMONS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMACIST
Mailing Address - Street 1:8356 S KENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60619-6414
Mailing Address - Country:US
Mailing Address - Phone:773-895-2605
Mailing Address - Fax:773-978-4520
Practice Address - Street 1:8356 S KENWOOD AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60619-6414
Practice Address - Country:US
Practice Address - Phone:773-895-2605
Practice Address - Fax:773-978-4520
Is Sole Proprietor?:No
Enumeration Date:2013-09-18
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL052034010183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist