Tiffany Aboagye, PHARMD
Individual provider Active NPI Pharmacist · Sauk Village, IL
NPI 1366710071 · NPPES record last updated Dec 8, 2011
Key facts
- NPI
- 1366710071
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 26023824A (IN)
- Practice address
- 2611 Marigold Dr
Apt 235
Sauk Village, IL 60411-5252 - Phone
- (708) 753-1308
- NPI assigned
- Dec 8, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051294711 | IL | MD | Pharmacist |
| 26023824A | IN | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051294711 | IL | |
| Pharmacist | 183500000X | 26023824A | IN | Yes |
Addresses
Primary practice location
2611 Marigold Dr
Apt 235
Sauk Village, IL 60411-5252
Mailing address
2611 Marigold Dr
Apt 235
Sauk Village, IL 60411-5252
Phone (708) 753-1308
Other providers in Sauk Village, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 8, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.