Provider Demographics
NPI:1932486719
Name:CHAPMAN, SHARLENE
Entity Type:Individual
Prefix:
First Name:SHARLENE
Middle Name:
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3145 W 147TH ST
Mailing Address - Street 2:
Mailing Address - City:POSEN
Mailing Address - State:IL
Mailing Address - Zip Code:60469-1438
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3145 W 147TH ST
Practice Address - Street 2:
Practice Address - City:POSEN
Practice Address - State:IL
Practice Address - Zip Code:60469-1438
Practice Address - Country:US
Practice Address - Phone:708-385-8922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-08
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051289193183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist