Healthcare Provider Details

I. General information

NPI: 1578658183
Provider Name (Legal Business Name): RICHARD JOSEPH ROONEY PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 SOUTH DAMEN AVENUE
CHICAGO IL
60612
US

IV. Provider business mailing address

6624 WESTMORELAND DRIVE
WOODRIDGE IL
60517
US

V. Phone/Fax

Practice location:
  • Phone: 312-569-7103
  • Fax: 312-569-8122
Mailing address:
  • Phone: 630-964-2669
  • Fax: 312-569-8122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number8487
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: