Provider Demographics
NPI:1437869591
Name:GAWRONSKI, CHARLES J (RPH)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:J
Last Name:GAWRONSKI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1221 S LEO CT
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-2388
Mailing Address - Country:US
Mailing Address - Phone:847-358-6385
Mailing Address - Fax:847-485-8181
Practice Address - Street 1:2875 W 19TH ST.
Practice Address - Street 2:SUITE 201
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60623
Practice Address - Country:US
Practice Address - Phone:773-762-1100
Practice Address - Fax:773-522-2020
Is Sole Proprietor?:No
Enumeration Date:2022-11-30
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-026542183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist