Provider Demographics
NPI:1417222704
Name:KUK, PHILIP (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:
Last Name:KUK
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 1:302 WILMOT RD
Mailing Address - Street 2:MS #3268
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-4618
Mailing Address - Country:US
Mailing Address - Phone:224-723-6109
Mailing Address - Fax:
Practice Address - Street 1:302 WILMOT RD
Practice Address - Street 2:MS #3268
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-4618
Practice Address - Country:US
Practice Address - Phone:224-723-6109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-20
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-040408183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist