Provider Demographics
NPI:1740590942
Name:PAULUS, ERIC JOHN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:JOHN
Last Name:PAULUS
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 1:77 RAND RD
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-1005
Mailing Address - Country:US
Mailing Address - Phone:847-460-7414
Mailing Address - Fax:847-298-5939
Practice Address - Street 1:77 RAND RD
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-1005
Practice Address - Country:US
Practice Address - Phone:847-460-7414
Practice Address - Fax:847-298-5939
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-21
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA212521835P0018X
IL051.2951441835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist