| Doctor Name: | MRS. LORA ETHELYN BERTELL |
| NPI Number: | 1063544617 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHARMD |
| License Number: | |
| Business Practice Address: | 11829 Banchary Rd Belvidere, IL - 610087175 |
| Business Phone Number: | 8158854424 |
| Business Fax Number: | |
| Mailing Address: | 11829 Banchary Rd, BELVIDERE |
| State: | IL |
| Postal Code: | 610087175 |
| Phone Number: | 8158854424 |
| Fax Number: | |
| NPI Enumeration Date: | 03/09/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1835X0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Pharmacy Service Providers |
| Taxonomy Classification: | Pharmacist |
| Taxonomy Specialization: | Oncology |
| Taxonomy Definition: | A licensed pharmacist who has demonstrated specialized knowledge and skill in developing, recommending, implementing, monitoring, and modifying pharmacotherapeutic plans to optimize outcomes in patients with malignant diseases. |