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General NPI Number Information
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NPI Number | 1780307363
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Entity Type | Individual
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Provider Name | DAVID GONZALEZ LUNA PHARMD
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Gender | Male
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Dates
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Enumeration Date | 09/20/2022
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Last Update Date | 09/20/2022
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Provider Practice Location Address
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Address Line | 2940 N ASHLAND AVE
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City | CHICAGO
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State | IL
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Zip | 60657-8905
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Country | US
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Telephone | 773-348-4155
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Fax |
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Provider Business Mailing Address
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Address Line | 163 RED OAK ST
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City | POPLAR GROVE
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State | IL
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Zip | 61065-8512
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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 | 051304998
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License Number State | IL
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