Provider Demographics
NPI:1992380448
Name:ADUNA, CORENNA LEE (CPHT)
Entity Type:Individual
Prefix:
First Name:CORENNA
Middle Name:LEE
Last Name:ADUNA
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2750 DUNDEE RD STE 9
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2600
Mailing Address - Country:US
Mailing Address - Phone:847-480-1000
Mailing Address - Fax:847-480-1988
Practice Address - Street 1:2750 DUNDEE RD STE 9
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2600
Practice Address - Country:US
Practice Address - Phone:847-480-1000
Practice Address - Fax:847-480-1988
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL049.215357183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician