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NPI Code Detail

MEDICARE: JOHN C GEBHARDT RPH

MEDICARE: JOHN C GEBHARDT RPH
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
1183500000XPharmacist051-027117IL

General Provider Information

NPI Number : 1649592593
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN C GEBHARDT RPH
Provider Business Mailing Address
First Line : 11000 S CICERO AVE
Second Line :
City : OAK LAWN
State : IL
Zip : 60453-5504
Country : US
Telephone Number : 708-424-6671
Fax Number : 708-424-7511
Provider Business Practice Location Address
First Line : 11000 S CICERO AVE
Second Line :
City : OAK LAWN
State : IL
Zip : 60453-5504
Country : US
Telephone Number : 708-424-6671
Fax Number : 708-424-7511
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2010
Last Update Date : 02/19/2010

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