Healthcare Provider Details

I. General information

NPI: 1811592256
Provider Name (Legal Business Name): STEVE PARASKOS PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2020
Last Update Date: 12/03/2020
Certification Date: 11/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34344 N US HIGHWAY 45
THIRD LAKE IL
60030-4031
US

IV. Provider business mailing address

34344 N US HIGHWAY 45
THIRD LAKE IL
60030-4031
US

V. Phone/Fax

Practice location:
  • Phone: 847-543-5441
  • Fax:
Mailing address:
  • Phone: 847-543-5441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051.286128
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: