Provider Demographics
NPI:1801239843
Name:CICHY, DANIEL ANTHONY (PHARM D)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ANTHONY
Last Name:CICHY
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1636 MILLER PARK WAY
Mailing Address - Street 2:
Mailing Address - City:WEST MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53214-3604
Mailing Address - Country:US
Mailing Address - Phone:414-385-9500
Mailing Address - Fax:414-533-6601
Practice Address - Street 1:1636 MILLER PARK WAY
Practice Address - Street 2:
Practice Address - City:WEST MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53214-3604
Practice Address - Country:US
Practice Address - Phone:414-385-9500
Practice Address - Fax:414-533-6601
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-09
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16916-40183500000X
IL051.295938183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist