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General NPI Number Information
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NPI Number | 1730224486
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Entity Type | Individual
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Provider Name | CRAIG ADLER MANDEL RPH
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Gender | Male
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 10/26/2010
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Provider Practice Location Address
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Address Line | 401 N MAIN ST
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City | GLEN ELLYN
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State | IL
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Zip | 60137-5101
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Country | US
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Telephone | 630-469-1414
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Fax |
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Provider Business Mailing Address
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Address Line | 563 DORSET AVE
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City | GLEN ELLYN
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State | IL
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Zip | 60137-5702
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Country | US
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Telephone | 630-469-6368
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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 | 05128142
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 049091215
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License Number State | IL
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