MS. CHAUNTA NICOLE WILLIS (NPI# 1063846335) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063846335 |
| Entity Type | Individual |
| Full Name | MS. CHAUNTA NICOLE WILLIS |
| Credential | CPHT |
| Practice Address |
3753 S Cottage Grove Ave Chicago IL 60653-1407 |
| Practice Telephone | 7734510712 |
| Practice Fax Number | 7734510714 |
| Mailing Telephone | 7734510712 |
| Mailing Fax Number | 7734510714 |
| Enumeration Date | 2013-08-22 |
| Last Update Date | 2013-08-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183700000X | Pharmacy Technician | 049168746 | IL | Pharmacy Service Providers |
| Street Address |
3753 S COTTAGE GROVE AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60653-1407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144206145 | Susan Barclay | Pediatrics | 3753 S Cottage Grove Ave, Chicago, IL 60653-1407 | 2005-12-21 |
| 1649650045 | Yan Duan | Internal Medicine | 3753 S Cottage Grove Ave, Chicago, IL 60653-1407 | 2015-06-02 |
| 1447506597 | Rizwana Syed | Internal Medicine | 3753 S Cottage Grove Ave, Chicago, IL 60653-1407 | 2012-07-26 |
| 1134425085 | Nasser A Boshra | Internal Medicine | 3753 S Cottage Grove Ave, Chicago, IL 60653-1407 | 2011-02-09 |
| 1922317528 | Maja Delibasic | Internal Medicine | 3753 S Cottage Grove Ave, Chicago, IL 60653-1407 | 2010-09-29 |
| 1760707947 | Kids Above All | Clinic/Center | 3753 S Cottage Grove Ave, 2nd Floor, Chicago, IL 60653-1407 | 2010-03-31 |
| 1881918134 | Abigail Monsalud Morrow | Nurse Practitioner | 3753 S Cottage Grove Ave, Chicago, IL 60653-1407 | 2010-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881215804 | Pamela Ann Brazelton-sykes | Counselor | Pioneer Gardens Supportive Living, 3800 S King Dr, Chicago, IL 60653 | 2020-04-30 |
| 1962915439 | Pickup Transport Lllp | Non-emergency Medical Transport (VAN) | 4418 S. Oakenwald Ave, Chicago, IL 60653 | 2017-11-07 |
| 1245758309 | Qi Wellness LLC | Case Management | 525 E 46th Place, Chicago, IL 60653 | 2017-09-08 |
| 1598202897 | Fadesire O Ajuwon | Registered Nurse | 4218 S King Dr, 1n, Chicago, IL 60653 | 2017-01-24 |
| 1013464619 | Roundys Supermarkets Inc | Pharmacy | 3857 S Dr Martin Luther King Jr Dr, Chicago, IL 60653 | 2016-09-01 |
| 1417384793 | Griffin Orthodontics PC | Dentist | 1040 E 47th Street, Chicago, IL 60653 | 2013-10-02 |
| 1114350659 | Carita Dale Johnson | Pharmacist | 3753 S. Cottage Grove Ave, 104, Chicago, IL 60653 | 2013-08-20 |
| 1245677848 | Mercy Diagnostic and Treatment Center | Clinic/Center | 3755 S Cottage Grove, Chicago, IL 60653 | 2013-05-23 |
| 1952745937 | Mercy Community Pharmacy At Oakwood Shores | Pharmacy | 3753 S. Cottage Grove, Chicago, IL 60653 | 2013-04-22 |
| 1386952315 | Jami S Little | Developmental Therapist | 617 East 41st, Chicago, IL 60653 | 2010-09-24 |
| Find all providers in zip 60653 | ||||
| Taxonomy Code | 183700000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacy Technician |
| A person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professional judgment of a pharmacist. |
| Notes: Source: Pharmacy Technician Certification Board, www.ptcb.org [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093320947 | David Li | Pharmacy Technician | 2848 S Quinn St Apt A, Chicago, IL 60608-5979 | 2020-09-08 |
| 1922612928 | Valentina Iliescu | Pharmacy Technician | 2440 N Luna Ave, Chicago, IL 60639-1335 | 2020-09-07 |
| 1679029995 | Meghan Robbins | Pharmacy Technician | 10428 S. Springfield, Chicago, IL 60655 | 2016-08-28 |
| 1952688111 | Tirrell Antoine Livingston | Pharmacy Technician | 7544 S Stony Island Ave, Chicago, IL 60649-3926 | 2011-11-15 |
| 1245511641 | Sarah Kim Cramer | Pharmacy Technician | 6040 S Harper Ave Apt 903, Chicago, IL 60637-2936 | 2011-08-30 |
| 1952553539 | Kathy Pham Tran | Pharmacy Technician | 920 W Lakeside Pl, Apt 1507, Chicago, IL 60640-5175 | 2008-10-15 |
| 1992328223 | Heather Jensky | Pharmacy Technician | 79 W Monroe St, Chicago, IL 60603-4901 | 2020-05-21 |
| 1154943074 | Diana Nguyen | Pharmacy Technician | 151 N State St, Chicago, IL 60601-3601 | 2020-05-13 |
| 1588283865 | Colton W Sherell | Pharmacy Technician | 4025 N Sheridan Rd, Chicago, IL 60613-2010 | 2020-04-15 |
| 1730733015 | Tanya Abraham | Pharmacy Technician | 201 E Huron St Ste 1-210, Chicago, IL 60611-3578 | 2019-07-25 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.