Provider Demographics
NPI:1346414265
Name:PASQUINELLI, ARTHUR B
Entity Type:Individual
Prefix:MR
First Name:ARTHUR
Middle Name:B
Last Name:PASQUINELLI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 S HARLEM AVE
Mailing Address - Street 2:
Mailing Address - City:PEOTONE
Mailing Address - State:IL
Mailing Address - Zip Code:60468-9189
Mailing Address - Country:US
Mailing Address - Phone:708-258-6811
Mailing Address - Fax:708-258-0468
Practice Address - Street 1:222 S HARLEM AVE
Practice Address - Street 2:
Practice Address - City:PEOTONE
Practice Address - State:IL
Practice Address - Zip Code:60468-9189
Practice Address - Country:US
Practice Address - Phone:708-258-6811
Practice Address - Fax:708-258-0468
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X, 1835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric
No183500000XPharmacy Service ProvidersPharmacist