Provider Demographics
NPI:1891573341
Name:POLLARD, MAKISHA (BS, MBA)
Entity Type:Individual
Prefix:MISS
First Name:MAKISHA
Middle Name:
Last Name:POLLARD
Suffix:
Gender:F
Credentials:BS, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13130 S SAINT LAWRENCE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60827-1344
Mailing Address - Country:US
Mailing Address - Phone:773-368-1580
Mailing Address - Fax:
Practice Address - Street 1:10013 GRAND AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN PARK
Practice Address - State:IL
Practice Address - Zip Code:60131-2546
Practice Address - Country:US
Practice Address - Phone:847-861-7702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program