Provider Demographics
NPI:1679846877
Name:LASKY, MEI-CHEN S (RPH)
Entity type:Individual
Prefix:
First Name:MEI-CHEN
Middle Name:S
Last Name:LASKY
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 1:267 COLUMBINE DR
Mailing Address - Street 2:
Mailing Address - City:CLARENDON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60514-1007
Mailing Address - Country:US
Mailing Address - Phone:630-789-8019
Mailing Address - Fax:
Practice Address - Street 1:5518 W CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60651-2726
Practice Address - Country:US
Practice Address - Phone:773-261-6664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-17
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051287316183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist