| Doctor Name: | PAMELA A EERNISSE |
| NPI Number: | 1427036151 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPM |
| License Number: | |
| Business Practice Address: | 9050 W 81st St Justice, IL - 604581350 |
| Business Phone Number: | 7085943500 |
| Business Fax Number: | 7085943524 |
| Mailing Address: | Po Box 967, TINLEY PARK |
| State: | IL |
| Postal Code: | 604770967 |
| Phone Number: | 3123372468 |
| Fax Number: | 3123376912 |
| NPI Enumeration Date: | 01/03/2006 |
| NPI Last Update Date: | 02/14/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |