Provider Demographics
NPI:1295037927
Name:GALIOTTO, MARY VERONICA (RPH)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:VERONICA
Last Name:GALIOTTO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MS
Other - First Name:MARY
Other - Middle Name:VERONICA
Other - Last Name:GALIOTTO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:307 N WESTERN
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-3135
Mailing Address - Country:US
Mailing Address - Phone:847-691-7444
Mailing Address - Fax:
Practice Address - Street 1:2920 N NARRAGANSETT
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60639
Practice Address - Country:US
Practice Address - Phone:773-637-1819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051033883183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist