Healthcare Provider Details

I. General information

NPI: 1194603266
Provider Name (Legal Business Name): OSCAR ESPARZA PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2025
Last Update Date: 08/26/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12290 S PULASKI RD
ALSIP IL
60803-1405
US

IV. Provider business mailing address

12525 S TRUMBULL AVE
ALSIP IL
60803-1033
US

V. Phone/Fax

Practice location:
  • Phone: 708-385-2006
  • Fax:
Mailing address:
  • Phone: 708-691-1955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051307146
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: