NPI 1003193962

George Bardahl, RPH

Practitioner Pharmacist Homewood, IL

Practice location

Address: 18461 Dixie Hwy, Homewood, IL 60430-3229
Phone: (708) 957-1640

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 051.040626 (IL)

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Registry record

NPI: 1003193962
Entity type: Individual
Sex (as registered): Male
NPI issued: 7 Nov 2011
Record last updated: 7 Nov 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.