Provider Demographics
NPI:1548546021
Name:KING-FRANKLIN, VANESSA DION (RPH, PHARMD)
Entity type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:DION
Last Name:KING-FRANKLIN
Suffix:
Gender:F
Credentials:RPH, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 ROSEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:CHICAGO HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60411-1150
Mailing Address - Country:US
Mailing Address - Phone:773-991-2734
Mailing Address - Fax:708-755-6473
Practice Address - Street 1:650 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:CHICAGO HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60411-2143
Practice Address - Country:US
Practice Address - Phone:708-755-0058
Practice Address - Fax:708-755-6473
Is Sole Proprietor?:No
Enumeration Date:2011-10-27
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-040528183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist