Provider Demographics
NPI:1558944652
Name:WOLEK, RICHARD BERNARD (PHARMD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:BERNARD
Last Name:WOLEK
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 1:1544 W RICHMOND ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-2835
Mailing Address - Country:US
Mailing Address - Phone:847-721-0006
Mailing Address - Fax:
Practice Address - Street 1:1544 W RICHMOND ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-2835
Practice Address - Country:US
Practice Address - Phone:847-721-0006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051292386183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist