Provider Demographics
NPI:1982990602
Name:PECHENIK, MASHA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MASHA
Middle Name:
Last Name:PECHENIK
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 1:18800 RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:MARENGO
Mailing Address - State:IL
Mailing Address - Zip Code:60152-9123
Mailing Address - Country:US
Mailing Address - Phone:847-890-1154
Mailing Address - Fax:
Practice Address - Street 1:18800 RIDGE LN
Practice Address - Street 2:
Practice Address - City:MARENGO
Practice Address - State:IL
Practice Address - Zip Code:60152-9123
Practice Address - Country:US
Practice Address - Phone:847-890-1154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.293409183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist