Provider Demographics
NPI:1518562248
Name:BOSOWSKI, ADRIAN CAMIL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ADRIAN
Middle Name:CAMIL
Last Name:BOSOWSKI
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 1:3615 N CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-2753
Mailing Address - Country:US
Mailing Address - Phone:773-283-2355
Mailing Address - Fax:
Practice Address - Street 1:3615 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-2753
Practice Address - Country:US
Practice Address - Phone:773-283-2355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-01
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051302383183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist