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General NPI Number Information
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NPI Number | 1841863354
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Entity Type | Individual
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Provider Name | ADRIAN KALATA PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/22/2021
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Last Update Date | 07/22/2021
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Provider Practice Location Address
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Address Line | 12659 S RIDGELAND AVE
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-1871
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Country | US
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Telephone | 708-385-0218
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Fax |
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Provider Business Mailing Address
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Address Line | 832 WARNER AVE
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City | LEMONT
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State | IL
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Zip | 60439-3974
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Country | US
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Telephone | 630-276-8054
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 051304034
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License Number State | IL
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