Provider Demographics
NPI:1376070821
Name:GLOVER, DARRYL GARRETT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DARRYL
Middle Name:GARRETT
Last Name:GLOVER
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 1:2021 MIDWEST RD STE 200
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1370
Mailing Address - Country:US
Mailing Address - Phone:510-740-4045
Mailing Address - Fax:
Practice Address - Street 1:2021 MIDWEST RD STE 200
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1370
Practice Address - Country:US
Practice Address - Phone:510-740-4045
Practice Address - Fax:630-206-1640
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0510390291835P2201X
CA456981835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL051039029OtherILLINOIS DEPARTMENT OF PROFESSIONAL REGULATIONS
CA45698OtherCALIFORNIA STATE BOARD OF PHARMACY