MEDICARE: MR. JOSEPH P PIENTO

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	051.038355	IL

General Provider Information

NPI Number	:	1740567205
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOSEPH P PIENTO

Provider Business Mailing Address
First Line	:	11237 ARROWHEAD TRL
Second Line	:
City	:	INDIAN HEAD PARK
State	:	IL
Zip	:	60525-4957
Country	:	US
Telephone Number	:	708-710-8632
Fax Number	:

Provider Business Practice Location Address
First Line	:	4700 GILBERT AVE
Second Line	:
City	:	WESTERN SPRINGS
State	:	IL
Zip	:	60558-1753
Country	:	US
Telephone Number	:	708-246-5120
Fax Number	:

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

Provider Enumeration Date	:	11/11/2011
Last Update Date	:	11/11/2011

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Directions to “ MR. JOSEPH P PIENTO ” Practice Location

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