Provider Demographics
NPI:1841571247
Name:WHITE, JULIE ANN (RPH)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:WHITE
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 1:191 N CLARK ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-6232
Mailing Address - Country:US
Mailing Address - Phone:312-634-0152
Mailing Address - Fax:312-634-0160
Practice Address - Street 1:191 N CLARK ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-6232
Practice Address - Country:US
Practice Address - Phone:312-634-0152
Practice Address - Fax:312-634-0160
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-287259183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist