Provider Demographics
NPI:1255937272
Name:HRAD, BRIAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:HRAD
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 1:610 S MAPLE AVE STE 1600
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60304-1096
Mailing Address - Country:US
Mailing Address - Phone:708-660-6822
Mailing Address - Fax:
Practice Address - Street 1:610 S MAPLE AVE STE 1600
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60304-1096
Practice Address - Country:US
Practice Address - Phone:708-660-6822
Practice Address - Fax:708-660-6821
Is Sole Proprietor?:No
Enumeration Date:2020-12-06
Last Update Date:2020-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051292052183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist