Provider Demographics
NPI:1962784041
Name:NALABOFF, DENISE L (RPH)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:L
Last Name:NALABOFF
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 1:2498 FIELDING DR
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-7757
Mailing Address - Country:US
Mailing Address - Phone:847-730-3156
Mailing Address - Fax:
Practice Address - Street 1:63 GREEN BAY RD
Practice Address - Street 2:
Practice Address - City:GLENCOE
Practice Address - State:IL
Practice Address - Zip Code:60022-4416
Practice Address - Country:US
Practice Address - Phone:847-835-8417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051290984183500000X
FLPS28508183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist