Provider Demographics
NPI:1770604092
Name:SPACCAPANICCIA, CASSANDRA MARIE (PHARM D)
Entity type:Individual
Prefix:MS
First Name:CASSANDRA
Middle Name:MARIE
Last Name:SPACCAPANICCIA
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:MS
Other - First Name:CASSANDRA
Other - Middle Name:MARIE
Other - Last Name:URBAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:4575 WEAVER PKWY
Mailing Address - Street 2:
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-4039
Mailing Address - Country:US
Mailing Address - Phone:630-505-0300
Mailing Address - Fax:630-836-0667
Practice Address - Street 1:4575 WEAVER PKWY
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-4039
Practice Address - Country:US
Practice Address - Phone:630-505-0300
Practice Address - Fax:630-836-0667
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist