Healthcare Provider Details

I. General information

NPI: 1497055982
Provider Name (Legal Business Name): TOMASZ DALECKI PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2010
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 N CLYBOURN AVE UNIT C104
CHICAGO IL
60610-2295
US

IV. Provider business mailing address

1500 N CLYBOURN AVE UNIT C104
CHICAGO IL
60610-2295
US

V. Phone/Fax

Practice location:
  • Phone: 312-475-9691
  • Fax: 312-475-9688
Mailing address:
  • Phone: 312-475-9691
  • Fax: 312-475-9688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number051286254
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: