Basic Information
| Provider Information | |||||||||
| NPI: | 1760474332 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DRABANT | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | MICHAEL | ||||||||
| NamePrefix: | |||||||||
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| Credential: | RPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5805 BROADWAY ST | ||||||||
| Address2: | |||||||||
| City: | RICHMOND | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600719534 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8156784577 | ||||||||
| FaxNumber: | 8157598090 | ||||||||
| Practice Location | |||||||||
| Address1: | 5805 BROADWAY ST | ||||||||
| Address2: | |||||||||
| City: | RICHMOND | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600719534 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8156784577 | ||||||||
| FaxNumber: | 8157598090 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/18/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | IL | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.