Provider Demographics
NPI:1851198568
Name:BAGGETT, CARLA NADRA (PHARMD)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:NADRA
Last Name:BAGGETT
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7120 S FAIRFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60629-2010
Mailing Address - Country:US
Mailing Address - Phone:773-682-2526
Mailing Address - Fax:
Practice Address - Street 1:7120 S FAIRFIELD AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60629-2010
Practice Address - Country:US
Practice Address - Phone:773-682-2526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-28
Last Update Date:2025-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051306685183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist