Provider Demographics
NPI:1750668406
Name:DELUCA, FRANK JOHN
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:JOHN
Last Name:DELUCA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 W ARMY TRAIL RD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60139-1971
Mailing Address - Country:US
Mailing Address - Phone:630-582-0065
Mailing Address - Fax:
Practice Address - Street 1:175 W ARMY TRAIL RD
Practice Address - Street 2:
Practice Address - City:GLENDALE HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60139-1971
Practice Address - Country:US
Practice Address - Phone:630-582-0065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-09
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-037542183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist