Provider Demographics
NPI:1306103171
Name:PARGO, CHESCA A (PHARM D)
Entity type:Individual
Prefix:DR
First Name:CHESCA
Middle Name:A
Last Name:PARGO
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:CHESCA
Other - Middle Name:A
Other - Last Name:LICIAGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:102 COMANCHE CIR
Mailing Address - Street 2:
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007-9371
Mailing Address - Country:US
Mailing Address - Phone:205-410-4080
Mailing Address - Fax:
Practice Address - Street 1:8001 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077
Practice Address - Country:US
Practice Address - Phone:800-553-7359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-18
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14933183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist