Provider Demographics
NPI:1245402429
Name:MCGAHAN, DENNIS J (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:J
Last Name:MCGAHAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15900 S. CICERO AVE.
Mailing Address - Street 2:PHARMACY DEPARTMENT
Mailing Address - City:OAK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60452
Mailing Address - Country:US
Mailing Address - Phone:708-817-0834
Mailing Address - Fax:708-633-4380
Practice Address - Street 1:15900 S. CICERO AVE.
Practice Address - Street 2:PHARMACY DEPARTMENT
Practice Address - City:OAK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60452
Practice Address - Country:US
Practice Address - Phone:708-817-0834
Practice Address - Fax:708-633-4380
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-28
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist