Provider Demographics
NPI:1720388705
Name:PHILBRICK, ALEXANDER HERBERT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:HERBERT
Last Name:PHILBRICK
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 1:856 N WINCHESTER AVE
Mailing Address - Street 2:#2
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-6701
Mailing Address - Country:US
Mailing Address - Phone:312-953-9323
Mailing Address - Fax:
Practice Address - Street 1:2021 W CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-5549
Practice Address - Country:US
Practice Address - Phone:312-953-9323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051290850183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist