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General NPI Number Information
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NPI Number | 1982364584
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Entity Type | Individual
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Provider Name | FRANK JOSEPH CARUSO IV PHARMD
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Gender | Male
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Dates
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Enumeration Date | 12/22/2021
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Last Update Date | 12/22/2021
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Provider Practice Location Address
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Address Line | 7251 LAKE ST
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City | RIVER FOREST
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State | IL
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Zip | 60305-2238
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Country | US
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Telephone | 708-366-9960
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Fax | 708-366-1585
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Provider Business Mailing Address
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Address Line | 2123 N 75TH AVE
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City | ELMWOOD PARK
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State | IL
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Zip | 60707-3149
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Country | US
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Telephone | 708-420-6534
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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 | 051304525
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License Number State | IL
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