Healthcare Provider Details

I. General information

NPI: 1548548522
Provider Name (Legal Business Name): CARLO FRANK GAGLIO PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2011
Last Update Date: 07/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2313 S MOUNT PROSPECT RD
DES PLAINES IL
60018-1811
US

IV. Provider business mailing address

1534 HEATHER LN
DES PLAINES IL
60018-1400
US

V. Phone/Fax

Practice location:
  • Phone: 847-635-3000
  • Fax: 847-635-8076
Mailing address:
  • Phone: 847-390-1055
  • Fax: 847-635-8076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051.038924
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number051.038924
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: