Provider Demographics
NPI:1114179520
Name:HANDLER, GERALD B (R PH)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:B
Last Name:HANDLER
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1657 W ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3201
Mailing Address - Country:US
Mailing Address - Phone:312-327-6157
Mailing Address - Fax:312-377-7983
Practice Address - Street 1:1657 W ADAMS ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3201
Practice Address - Country:US
Practice Address - Phone:312-327-6157
Practice Address - Fax:312-377-7983
Is Sole Proprietor?:No
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-023033183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist