Provider Demographics
NPI:1437677705
Name:DECASTRO, NONA GAYLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NONA
Middle Name:GAYLE
Last Name:DECASTRO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BAXTER PKWY # DF41E
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-4625
Mailing Address - Country:US
Mailing Address - Phone:224-948-1358
Mailing Address - Fax:
Practice Address - Street 1:1 BAXTER PKWY # DF41E
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-4625
Practice Address - Country:US
Practice Address - Phone:224-948-1358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-06
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.294234183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist