=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407993025
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CRAIG JAMES DAGGETT PHARM D
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/31/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 333 RIDGE RD PARKWAY DRUGS
-----------------------------------------------------
City | WILMETTE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60091-3217
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-256-1000
-----------------------------------------------------
Fax | 847-256-2675
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1872 N CLYBOURN AVE #113
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60614-4964
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 773-454-4792
-----------------------------------------------------
Fax | 847-256-2675
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------