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General NPI Number Information
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NPI Number | 1841164761
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Entity Type | Individual
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Provider Name | BRIAN KENNETH ALFREDO PHARMD
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Gender | Male
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Dates
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Enumeration Date | 10/02/2025
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 30 W MONROE ST STE 1200
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City | CHICAGO
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State | IL
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Zip | 60603-2420
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Country | US
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Telephone | 855-932-2073
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Fax |
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Provider Business Mailing Address
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Address Line | 2949 GRANDVIEW DR
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City | FAIRLAWN
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State | OH
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Zip | 44333-9106
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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 | 03443743
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License Number State | OH
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