Healthcare Provider Details

I. General information

NPI: 1114854312
Provider Name (Legal Business Name): RONALD HAUSNER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

546 TRUMAN ST
BOLINGBROOK IL
60440-9040
US

IV. Provider business mailing address

546 TRUMAN ST
BOLINGBROOK IL
60440-9040
US

V. Phone/Fax

Practice location:
  • Phone: 630-527-3606
  • Fax:
Mailing address:
  • Phone: 630-527-3606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License Number051296070
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: