Provider Demographics
NPI:1134218183
Name:KUCHTA, ANN M (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:M
Last Name:KUCHTA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 61ST ST
Mailing Address - Street 2:
Mailing Address - City:COUNTRYSIDE
Mailing Address - State:IL
Mailing Address - Zip Code:60525-3945
Mailing Address - Country:US
Mailing Address - Phone:708-354-2517
Mailing Address - Fax:708-352-0591
Practice Address - Street 1:833 S WOOD ST
Practice Address - Street 2:ROOM 164 M/C 883
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-7229
Practice Address - Country:US
Practice Address - Phone:312-996-6686
Practice Address - Fax:312-996-0369
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy