Arthur George Wargo
Individual provider Active NPI Pharmacist · Mazon, IL
NPI 1114514593 · NPPES record last updated Dec 31, 2020
Key facts
- NPI
- 1114514593
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 051039189 (IL)
- Practice address
- 2510 S Hadden Rd
Mazon, IL 60444-6266 - Phone
- (815) 343-0519
- NPI assigned
- Dec 31, 2020
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051039189 | IL | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist |
183500000X | 051039189 | IL | Yes |
Addresses
Primary practice location
2510 S Hadden Rd
Mazon, IL 60444-6266
Mailing address
2510 S Hadden Rd
Mazon, IL 60444-6266
Phone (815) 343-0519
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | agw1969 | Direct |
Other providers in Mazon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 31, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.