Provider Demographics
NPI:1740401777
Name:UGLIETTI, KRISTINE M (RPH)
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:M
Last Name:UGLIETTI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9128 WOODWARD AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IN
Mailing Address - Zip Code:46322-2359
Mailing Address - Country:US
Mailing Address - Phone:847-916-4599
Mailing Address - Fax:847-916-4114
Practice Address - Street 1:3030 CULLERTON ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN PARK
Practice Address - State:IL
Practice Address - Zip Code:60131-2205
Practice Address - Country:US
Practice Address - Phone:847-916-4599
Practice Address - Fax:847-916-4114
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26017731183500000X
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist