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General NPI Number Information
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NPI Number | 1518367259
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Entity Type | Individual
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Provider Name | LUCAS SEDLAK PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/29/2014
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 1616 SHERMAN AVE
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City | EVANSTON
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State | IL
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Zip | 60201
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Country | US
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Telephone | 847-491-0127
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Fax | 833-262-5480
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Provider Business Mailing Address
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Address Line | 1616 SHERMAN AVE
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City | EVANSTON
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State | IL
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Zip | 60201-5621
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Country | US
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Telephone | 847-491-0127
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Fax | 833-262-5480
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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 | 17608-40
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License Number State | WI
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