Provider Demographics
NPI:1780704221
Name:GRAUER, STUART M (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:STUART
Middle Name:M
Last Name:GRAUER
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7051 N KEDVALE AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-2313
Mailing Address - Country:US
Mailing Address - Phone:847-673-5787
Mailing Address - Fax:847-673-5787
Practice Address - Street 1:7051 N KEDVALE AVE
Practice Address - Street 2:
Practice Address - City:LINCOLNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60712-2313
Practice Address - Country:US
Practice Address - Phone:847-673-5787
Practice Address - Fax:847-673-5787
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist