Healthcare Provider Details

I. General information

NPI: 1871874727
Provider Name (Legal Business Name): DON HOAK PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2011
Last Update Date: 09/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 W LAKE ST
MELROSE PARK IL
60160-4039
US

IV. Provider business mailing address

1225 W LAKE ST
MELROSE PARK IL
60160-4039
US

V. Phone/Fax

Practice location:
  • Phone: 708-938-7650
  • Fax: 708-938-7288
Mailing address:
  • Phone: 708-938-7650
  • Fax: 708-938-7288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051035959
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: