Provider Demographics
NPI:1770170631
Name:PAJARILLO, DENISE VICTORIA PACIFICO (RPH)
Entity type:Individual
Prefix:
First Name:DENISE VICTORIA
Middle Name:PACIFICO
Last Name:PAJARILLO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 CANOPY DR APT 304
Mailing Address - Street 2:
Mailing Address - City:ROUND LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60073-5817
Mailing Address - Country:US
Mailing Address - Phone:847-641-0518
Mailing Address - Fax:
Practice Address - Street 1:1229 W IL ROUTE 134
Practice Address - Street 2:
Practice Address - City:ROUND LAKE
Practice Address - State:IL
Practice Address - Zip Code:60073-9725
Practice Address - Country:US
Practice Address - Phone:847-740-6795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0513013721835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist