MEDICARE: DR. PAUL SETLAK B.S., PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	51291219	IL

General Provider Information

NPI Number	:	1740257047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL SETLAK B.S., PHARM.D.

Provider Business Mailing Address
First Line	:	126 S HUDSON ST
Second Line	:
City	:	WESTMONT
State	:	IL
Zip	:	60559-1934
Country	:	US
Telephone Number	:	312-758-7762
Fax Number	:

Provider Business Practice Location Address
First Line	:	126 S HUDSON ST
Second Line	:
City	:	WESTMONT
State	:	IL
Zip	:	60559-1934
Country	:	US
Telephone Number	:	312-758-7762
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2006
Last Update Date	:	09/20/2016

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