Healthcare Provider Details

I. General information

NPI: 1255298840
Provider Name (Legal Business Name): MICHAEL SZULAKIEWICZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1403 WAUKEGAN RD
GLENVIEW IL
60025-2120
US

IV. Provider business mailing address

1403 WAUKEGAN RD
GLENVIEW IL
60025-2120
US

V. Phone/Fax

Practice location:
  • Phone: 847-998-1442
  • Fax:
Mailing address:
  • Phone: 847-998-1442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051307949
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: