Provider Demographics
NPI:1285245340
Name:VINCI, KRISTINA ANNE (PHARMD)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:ANNE
Last Name:VINCI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:ANNE
Other - Last Name:CHMIEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4801 N LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-1915
Mailing Address - Country:US
Mailing Address - Phone:773-561-2526
Mailing Address - Fax:
Practice Address - Street 1:4801 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-1915
Practice Address - Country:US
Practice Address - Phone:773-561-2526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051298632183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist