Healthcare Provider Details

I. General information

NPI: 1508922980
Provider Name (Legal Business Name): RICHARD ANZALONE PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 W. TAYLOR STREET UIC ONCOLOGY PHARMACY ROOM 1411
CHICAGO IL
60612
US

IV. Provider business mailing address

691 KRUK ST
LEMONT IL
60439-4367
US

V. Phone/Fax

Practice location:
  • Phone: 312-996-6985
  • Fax:
Mailing address:
  • Phone: 312-996-6985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: