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MR. STEPHEN RUDAWSKI BSPHARM

>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1972909059

Individual Registrant:
MR. STEPHEN  RUDAWSKI BSPHARM
Gender: M
Sole Proprietor

Location and contact information for practice:
161 S US HIGHWAY 12  FOX LAKE, IL 60020-1796 US
Tel: 847-587-0505  Fax: 847-587-2633

Contact information for business:
161 S US HIGHWAY 12  FOX LAKE, IL 60020-1796 US
Tel: 847-587-0505  Fax: 847-587-2633

Registration Information:
NPI: 1972909059
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers
Pharmacist
IL051031771
N1835P1200XPharmacy Service Providers
Pharmacist
IL051031771

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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