Bolad Inc

Primary specialty

PharmacistTaxonomy code 183500000X

License

051287521 Issued in IL

Legal business name

BOLAD INC

Practice address

426 N Milwaukee Ave
Libertyville, IL 60048-2248

Phone

(847) 362-2005

Fax

(847) 362-1304

NPI assigned

Jan 19, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Beau S Diab, RPH FACVP

Title

President

Phone

(847) 362-2005

Specialties & licenses 1

Addresses

Other names 1

• PETRANEK'S PHARMACY Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1730232133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 N MILWAUKEE AVE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600482248",
            "telephone_number": "847-362-2005",
            "fax_number": "847-362-1304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 N MILWAUKEE AVE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600482248",
            "telephone_number": "847-362-2005",
            "fax_number": "847-362-1304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOLAD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "DIAB",
        "authorized_official_first_name": "BEAU",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-362-2005",
        "authorized_official_credential": "RPH FACVP"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051287521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PETRANEK'S PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lisa S Block, LCPC
• Misty Lynn Blomquist, L.AC
• Kelsey Rae George Bloom, PT, DPT
• Katherine Blum, MS, MED
• Bianca Bockwinkel
• Gloria Boland, BSN, RN, CDCES
• Michelle Bolano, D.P.T.
• Katherine Elizabeth Booras, NCC, LCPC, MA, BS
• Erin Borcia
• Nancy Lynn Borkman, M.S.C.C.C.-SLP

• Pharmacist in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.