Provider Demographics
NPI:1972803351
Name:ARTATES, JESSICA PAZ (PHARMD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:PAZ
Last Name:ARTATES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:PAZ
Other - Last Name:COSTES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1340 S CANAL ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-5208
Mailing Address - Country:US
Mailing Address - Phone:312-850-0398
Mailing Address - Fax:312-850-9885
Practice Address - Street 1:1340 S CANAL ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-5208
Practice Address - Country:US
Practice Address - Phone:312-850-0398
Practice Address - Fax:312-850-9885
Is Sole Proprietor?:No
Enumeration Date:2010-11-01
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-293021183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist