Provider Demographics
NPI:1437233228
Name:STANKEWICZ, TODD M (RPH)
Entity type:Individual
Prefix:MR
First Name:TODD
Middle Name:M
Last Name:STANKEWICZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 N. MICHIGAN AVE.
Mailing Address - Street 2:SUITE 600
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601
Mailing Address - Country:US
Mailing Address - Phone:312-353-0338
Mailing Address - Fax:312-777-0021
Practice Address - Street 1:233 N MICHIGAN AVE
Practice Address - Street 2:SUITE 600
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-5519
Practice Address - Country:US
Practice Address - Phone:312-353-0338
Practice Address - Fax:312-353-5927
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-286316183500000X
MN115373-6183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist