MEDICARE: DR. BRIAN FRANCIS KORUS PHAMRD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	051300092	IL

General Provider Information

NPI Number	:	1124629720
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN FRANCIS KORUS PHAMRD

Provider Business Mailing Address
First Line	:	1910 JUNIPER DR
Second Line	:
City	:	MAHOMET
State	:	IL
Zip	:	61853-9294
Country	:	US
Telephone Number	:	954-562-7929
Fax Number	:

Provider Business Practice Location Address
First Line	:	4101 N VERMILION ST STE A
Second Line	:
City	:	DANVILLE
State	:	IL
Zip	:	61834-5997
Country	:	US
Telephone Number	:	217-443-9587
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2020
Last Update Date	:	11/02/2020

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