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General NPI Number Information
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NPI Number | 1639777329
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Entity Type | Individual
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Provider Name | SPENCER E HARPE PHARMD, PHD, MPH
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Gender | Male
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Dates
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Enumeration Date | 10/14/2020
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Last Update Date | 10/14/2020
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Provider Practice Location Address
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Address Line | 555 31ST ST
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-1235
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Country | US
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Telephone | 630-515-6249
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Fax |
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Provider Business Mailing Address
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Address Line | 509 MARENGO AVE
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City | FOREST PARK
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State | IL
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Zip | 60130-1914
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Country | US
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Telephone | 614-619-1995
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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 | E-09508
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License Number State | MS
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