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NPI Code Detail

MEDICARE: CARLEY VENVERTLOH PHARMD

MEDICARE: CARLEY VENVERTLOH PHARMD
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
1183500000XPharmacist051304211IL

General Provider Information

NPI Number : 1427727312
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLEY VENVERTLOH PHARMD
Provider Business Mailing Address
First Line : 900 NORTHWEST HWY
Second Line :
City : FOX RIVER GROVE
State : IL
Zip : 60021-1914
Country : US
Telephone Number : 847-639-0376
Fax Number :
Provider Business Practice Location Address
First Line : 900 NORTHWEST HWY
Second Line :
City : FOX RIVER GROVE
State : IL
Zip : 60021-1914
Country : US
Telephone Number : 847-639-0376
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2021
Last Update Date : 09/13/2021

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Directions to “ CARLEY VENVERTLOH PHARMD” Practice Location

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