Healthcare Provider Details

I. General information

NPI: 1992086987
Provider Name (Legal Business Name): EGON KAHN R.PH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2011
Last Update Date: 09/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2313 S. MT. PROSPECT ROAD
DES PLAINES IL
60018
US

IV. Provider business mailing address

2404 AUGUSTA WAY
HIGHLAND PARK IL
60035-1809
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051025728
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: