Basic Information
| Provider Information | |||||||||
| NPI: | 1326767211 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OHALE | ||||||||
| FirstName: | MARIAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHARMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | ST. BERNARD HOSPITAL AMBULATORY CARE CENTER PHARMACY | ||||||||
| Address2: | 6307 S. STEWART AVENUE, RM 101 | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60621 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7734201560 | ||||||||
| FaxNumber: | 7734201564 | ||||||||
| Practice Location | |||||||||
| Address1: | ST. BERNARD HOSPITAL AMBULATORY CARE CENTER PHARMACY | ||||||||
| Address2: | 6307 S. STEWART AVENUE, RM 101 | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60621 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7734201560 | ||||||||
| FaxNumber: | 7734201564 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/24/2022 | ||||||||
| LastUpdateDate: | 08/24/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 051301954 | IL | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.