Healthcare Provider Details

I. General information

NPI: 1255944468
Provider Name (Legal Business Name): JAMES HAROLD SNIEGOWSKI RPH, BS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2020
Last Update Date: 08/27/2020
Certification Date: 08/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8639 S CICERO AVE
CHICAGO IL
60652-3505
US

IV. Provider business mailing address

1237 QUAIL RUN AVE
BOLINGBROOK IL
60490-5403
US

V. Phone/Fax

Practice location:
  • Phone: 773-284-6332
  • Fax: 773-284-8186
Mailing address:
  • Phone: 630-632-3199
  • Fax: 773-284-8186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: