MEDICARE: DR. JOHN JOSEPH PRESTIANNI III PHARM.D

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	051300703	IL

General Provider Information

NPI Number	:	1285152314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN JOSEPH PRESTIANNI III PHARM.D

Provider Business Mailing Address
First Line	:	5131 N NORMANDY AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60656-3737
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7401 W LAWRENCE AVE
Second Line	:
City	:	HARWOOD HEIGHTS
State	:	IL
Zip	:	60706-3411
Country	:	US
Telephone Number	:	708-867-8564
Fax Number	:

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

Provider Enumeration Date	:	09/08/2017
Last Update Date	:	03/17/2018

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