Provider Demographics
NPI:1386408060
Name:AZUBUIKE, LYNDA C (RPH)
Entity type:Individual
Prefix:DR
First Name:LYNDA
Middle Name:C
Last Name:AZUBUIKE
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 1:17702 ARLINGTON LN
Mailing Address - Street 2:
Mailing Address - City:HAZEL CREST
Mailing Address - State:IL
Mailing Address - Zip Code:60429-2008
Mailing Address - Country:US
Mailing Address - Phone:773-865-1688
Mailing Address - Fax:
Practice Address - Street 1:17702 ARLINGTON LN
Practice Address - Street 2:
Practice Address - City:HAZEL CREST
Practice Address - State:IL
Practice Address - Zip Code:60429-2008
Practice Address - Country:US
Practice Address - Phone:773-865-1688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT033.0135280183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist