Provider Demographics
NPI:1508065475
Name:EMMERSON, TINA S (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TINA
Middle Name:S
Last Name:EMMERSON
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 1:1860 S ARLINGTON HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-3764
Mailing Address - Country:US
Mailing Address - Phone:847-439-8892
Mailing Address - Fax:847-439-7751
Practice Address - Street 1:1860 S ARLINGTON HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HTS
Practice Address - State:IL
Practice Address - Zip Code:60005-3764
Practice Address - Country:US
Practice Address - Phone:847-439-8892
Practice Address - Fax:847-439-7751
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist