Provider Demographics
NPI:1689798225
Name:DEBENEDICTIS, FRANK (RPH)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:DEBENEDICTIS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 RENAISSANCE PL UNIT 720
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-3639
Mailing Address - Country:US
Mailing Address - Phone:630-205-9363
Mailing Address - Fax:
Practice Address - Street 1:1127 S YORK RD
Practice Address - Street 2:
Practice Address - City:BENSENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60106-3342
Practice Address - Country:US
Practice Address - Phone:630-238-0181
Practice Address - Fax:630-238-0192
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL51-31568183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist