Individual
KEVIN BACIGALUPO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
5000 S 5TH AVE, BUILDING 200 ROOM B 128 H, HINES, IL 60141-3030
(708) 202-8387
(708) 202-2088
Mailing address
5000 S 5TH AVE, BUILDING 200 ROOM B 128 H, HINES, IL 60141-3030
(708) 202-8387
(708) 202-2088
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
051292633
IL
1835G0303X
Geriatric Pharmacist
Primary
051292633
IL
1835P1200X
Pharmacotherapy Pharmacist
051292633
IL
Other
Enumeration date
07/18/2008
Last updated
11/13/2023
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