Edwin J Boklewski, R.PH.

Individual provider Active NPI Pharmacist · Elk Grove Village, IL

NPI 1255450359 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1255450359
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
Practice address
980 Elk Grove Town Ctr
Elk Grove Village, IL 60007-3754
Phone
(847) 758-8524
Fax
(847) 758-8545
NPI assigned
Mar 28, 2007
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
051.027532ILMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X IL Yes

Addresses

Primary practice location

980 Elk Grove Town Ctr
Elk Grove Village, IL 60007-3754

Mailing address

163 Ridgewood Ave
Bensenville, IL 60106-2036
Phone (630) 595-8469

Other providers in Elk Grove Village, IL

All providers in Elk Grove Village, IL · Pharmacist in Illinois

Sources for this page

Verify at the official NPI Registry.