Provider Demographics
NPI:1922042837
Name:SCALZITTI, CHRISTOPHER H (RPH)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:H
Last Name:SCALZITTI
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 1:860 SUMMIT ST
Mailing Address - Street 2:112
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60120-5145
Mailing Address - Country:US
Mailing Address - Phone:847-742-7740
Mailing Address - Fax:
Practice Address - Street 1:860 SUMMIT ST
Practice Address - Street 2:112
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60120-5145
Practice Address - Country:US
Practice Address - Phone:847-742-7740
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL363372346002Medicaid
IL1218570001Medicare ID - Type Unspecified