Healthcare Provider Details

I. General information

NPI: 1215169859
Provider Name (Legal Business Name): MICHAEL JOSEPH OLIVERI PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2009
Last Update Date: 08/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7329 S CASS AVE
DARIEN IL
60561-3660
US

IV. Provider business mailing address

7329 S CASS AVE
DARIEN IL
60561-3660
US

V. Phone/Fax

Practice location:
  • Phone: 630-852-0070
  • Fax:
Mailing address:
  • Phone: 630-852-0070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051.293671
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: