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General NPI Number Information
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NPI Number | 1598658726
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Entity Type | Individual
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Provider Name | GARY BLOCK PHARMD
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Gender | Male
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Dates
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Enumeration Date | 05/29/2025
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 3249 OAK PARK AVE
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City | BERWYN
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State | IL
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Zip | 60402-0715
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Country | US
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Telephone | 708-783-3433
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Fax |
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Provider Business Mailing Address
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Address Line | 11561 BROOKWOOD DR
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City | ORLAND PARK
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State | IL
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Zip | 60467-6069
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Country | US
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Telephone | 708-717-3863
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 051.037041
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License Number State | IL
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