MEDICARE: DR. CARLO FRANK GAGLIO 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
1	183500000X	Pharmacist	051.038924	IL
2	1835G0303X	Geriatric Pharmacist	051.038924	IL

General Provider Information

NPI Number	:	1548548522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARLO FRANK GAGLIO PHARMD

Provider Business Mailing Address
First Line	:	1534 HEATHER LN
Second Line	:
City	:	DES PLAINES
State	:	IL
Zip	:	60018-1400
Country	:	US
Telephone Number	:	847-390-1055
Fax Number	:	847-635-8076

Provider Business Practice Location Address
First Line	:	2313 S MOUNT PROSPECT RD
Second Line	:
City	:	DES PLAINES
State	:	IL
Zip	:	60018-1811
Country	:	US
Telephone Number	:	847-635-3000
Fax Number	:	847-635-8076

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

Provider Enumeration Date	:	07/25/2011
Last Update Date	:	07/25/2011

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