Healthcare Provider Details

I. General information

NPI: 1124994652
Provider Name (Legal Business Name): LUKE DAREK OCIESIELSKI PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2025
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1763 W HOWARD ST
CHICAGO IL
60626-1626
US

IV. Provider business mailing address

5600 N SHERIDAN RD APT 7B
CHICAGO IL
60660-4839
US

V. Phone/Fax

Practice location:
  • Phone: 773-274-1293
  • Fax:
Mailing address:
  • Phone: 708-953-2584
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051307429
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: