Healthcare Provider Details

I. General information

NPI: 1962497883
Provider Name (Legal Business Name): JOSEPH RICHARD GERA R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/16/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7435 W TALCOTT AVE
CHICAGO IL
60631-3707
US

IV. Provider business mailing address

7435 W TALCOTT AVE
CHICAGO IL
60631-3707
US

V. Phone/Fax

Practice location:
  • Phone: 773-792-5037
  • Fax: 773-792-7949
Mailing address:
  • Phone: 773-792-5037
  • Fax: 773-792-7949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: