Provider Demographics
NPI:1871873349
Name:ABASOLO, ELAINE ANNE (PHARMD)
Entity type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:ANNE
Last Name:ABASOLO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6335 SARATOGA AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60516-2740
Mailing Address - Country:US
Mailing Address - Phone:630-222-2198
Mailing Address - Fax:
Practice Address - Street 1:1295 LILY CACHE LN
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60490-4500
Practice Address - Country:US
Practice Address - Phone:630-226-5839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-27
Last Update Date:2011-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.294121183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist