Provider Demographics
NPI:1396824645
Name:GERACI, MARK C (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:C
Last Name:GERACI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
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Mailing Address - Street 1:728 S HARVEY AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60304-1519
Mailing Address - Country:US
Mailing Address - Phone:708-786-7866
Mailing Address - Fax:708-786-7989
Practice Address - Street 1:1ST AVENUE 1 BLOCK NORTH OF CERMAK
Practice Address - Street 2:BUILDING 37 ROOM 139
Practice Address - City:HINES
Practice Address - State:IL
Practice Address - Zip Code:60141
Practice Address - Country:US
Practice Address - Phone:708-786-7866
Practice Address - Fax:708-786-7989
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL1835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology