Healthcare Provider Details

I. General information

NPI: 1104120229
Provider Name (Legal Business Name): STEVEN WAYNE BELLEN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2011
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 S CUMBERLAND AVE
PARK RIDGE IL
60068-5235
US

IV. Provider business mailing address

1900 S CUMBERLAND AVE
PARK RIDGE IL
60068-5235
US

V. Phone/Fax

Practice location:
  • Phone: 847-696-3846
  • Fax: 847-696-3486
Mailing address:
  • Phone: 847-696-3846
  • Fax: 847-696-3486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number051294719
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: