Provider Demographics
NPI:1013517853
Name:ASHINZE, EMMANUEL (PHARMD)
Entity Type:Individual
Prefix:
First Name:EMMANUEL
Middle Name:
Last Name:ASHINZE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4440 S VINCENNES AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60653-3414
Mailing Address - Country:US
Mailing Address - Phone:773-350-6093
Mailing Address - Fax:
Practice Address - Street 1:8331 S STEWART AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60620-1728
Practice Address - Country:US
Practice Address - Phone:773-783-0859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051286714183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist