Provider Demographics
NPI:1003930082
Name:MARX, BERNARD M (RPH)
Entity Type:Individual
Prefix:MR
First Name:BERNARD
Middle Name:M
Last Name:MARX
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4041 LINDENWOOD LN
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-1125
Mailing Address - Country:US
Mailing Address - Phone:847-924-7726
Mailing Address - Fax:847-205-7585
Practice Address - Street 1:6009 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60660-2500
Practice Address - Country:US
Practice Address - Phone:773-769-1259
Practice Address - Fax:773-769-3440
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist