1407845803 NPI number — DR. PETER V TORTORICE RPH PHARM D

Table of content: DR. PETER V TORTORICE RPH PHARM D (NPI 1407845803)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407845803 NPI number — DR. PETER V TORTORICE RPH PHARM D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TORTORICE
Provider First Name:
PETER
Provider Middle Name:
V
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
RPH PHARM D
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407845803
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3610 PAYSPHERE CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60674-0036
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-585-7000
Provider Business Mailing Address Fax Number:
847-240-0993

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8915 W GOLF RD
Provider Second Line Business Practice Location Address:
FL 1
Provider Business Practice Location Address City Name:
NILES
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60714-5905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-827-9060
Provider Business Practice Location Address Fax Number:
847-827-7196
Provider Enumeration Date:
10/18/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com