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General NPI Number Information
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NPI Number | 1588743934
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Entity Type | Individual
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Provider Name | VINCENT CALABRESE PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1ST AVENUE - 1 BLOCK N OF CERMAK RD BUILDING 37, ROOM 139
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City | HINES
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State | IL
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Zip | 60141
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Country | US
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Telephone | 708-786-7862
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Fax |
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Provider Business Mailing Address
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Address Line | 1130 S LOMBARD AVE UNIT 1
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City | OAK PARK
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State | IL
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Zip | 60304-2213
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Country | US
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Telephone |
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Fax |
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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 | 28187
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License Number State | FL
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