Provider Demographics
NPI:1063135028
Name:HENCH, KARL JOSEPH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KARL
Middle Name:JOSEPH
Last Name:HENCH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3418 W FOSTER AVE APT 301
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-4889
Mailing Address - Country:US
Mailing Address - Phone:773-791-8611
Mailing Address - Fax:
Practice Address - Street 1:3780 WILLOW RD
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-6146
Practice Address - Country:US
Practice Address - Phone:847-326-1201
Practice Address - Fax:847-326-1244
Is Sole Proprietor?:No
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051297693183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist