Basic Information
Provider Information
NPI: 1558939785
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCDEE
FirstName: DARINA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PHARMD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9660 LOIS DR APT F
Address2:  
City: DES PLAINES
State: IL
PostalCode: 600161883
CountryCode: US
TelephoneNumber: 8473126494
FaxNumber:  
Practice Location
Address1: 3001 GREEN BAY RD
Address2:  
City: NORTH CHICAGO
State: IL
PostalCode: 600643048
CountryCode: US
TelephoneNumber: 2246104319
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/14/2021
LastUpdateDate: 06/14/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/14/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000X051.301281ILY Pharmacy Service ProvidersPharmacist 

No ID Information.


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