Individual
ELLEN CHACKUNKAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1801 W TAYLOR ST, SUITE 3C, CHICAGO, IL 60612-4795
(312) 355-0117
Mailing address
833 S WOOD ST, SUITE 164, CHICAGO, IL 60612-7229
Taxonomy
Speciality
Code
Description
License number
State
1835P2201X
Ambulatory Care Pharmacist
Primary
051298546
IL
Other
Enumeration date
08/10/2016
Last updated
08/10/2016
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