Healthcare Provider Details

I. General information

NPI: 1659285864
Provider Name (Legal Business Name): MICHAEL DAVID SPECK PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

441 S STATE ST
ROCHESTER IL
62563-9297
US

IV. Provider business mailing address

441 S STATE ST
ROCHESTER IL
62563-9297
US

V. Phone/Fax

Practice location:
  • Phone: 217-576-7028
  • Fax: 217-576-7029
Mailing address:
  • Phone: 217-576-7028
  • Fax: 217-576-7029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051.295193
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: