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General NPI Number Information
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NPI Number | 1477764355
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Entity Type | Individual
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Provider Name | MARC E ALLGOOD PHARM D.
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Gender | Male
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3030 CULLERTON ST
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City | FRANKLIN PARK
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State | IL
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Zip | 60131-2205
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Country | US
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Telephone | 847-916-4713
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Fax | 847-916-4806
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Provider Business Mailing Address
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Address Line | 22362 LONG GROVE RD
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City | DEER PARK
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State | IL
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Zip | 60010-3737
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Country | US
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Telephone | 847-438-3110
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Fax | 847-916-4806
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 51290088
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 18555
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 10693
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License Number State | NE
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