Provider Demographics
NPI:1386262822
Name:SIMALE, ALICIA CRISTINA (PHARMD)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:CRISTINA
Last Name:SIMALE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:CRISTINA
Other - Last Name:MONTELONGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2765 CHATEAU DR
Mailing Address - Street 2:
Mailing Address - City:DYER
Mailing Address - State:IN
Mailing Address - Zip Code:46311-2173
Mailing Address - Country:US
Mailing Address - Phone:219-433-5955
Mailing Address - Fax:
Practice Address - Street 1:2401 RIDGE RD
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IN
Practice Address - Zip Code:46322-1565
Practice Address - Country:US
Practice Address - Phone:219-838-1414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-10
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051300734183500000X
IN26027401A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist