Healthcare Provider Details

I. General information

NPI: 1568588259
Provider Name (Legal Business Name): ANGELO DAKLARAS PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

678 N YORK ST
ELMHURST IL
60126-1605
US

IV. Provider business mailing address

678 N YORK ST
ELMHURST IL
60126-1605
US

V. Phone/Fax

Practice location:
  • Phone: 630-782-0031
  • Fax:
Mailing address:
  • Phone: 630-782-0031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number051.291181
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: