Provider Demographics
NPI:1316461080
Name:BOCIAN, CHARLIE PIERRE (PHARMD, MBA)
Entity type:Individual
Prefix:DR
First Name:CHARLIE
Middle Name:PIERRE
Last Name:BOCIAN
Suffix:
Gender:M
Credentials:PHARMD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 W. OAKTON STREET
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60018
Mailing Address - Country:US
Mailing Address - Phone:847-803-0181
Mailing Address - Fax:
Practice Address - Street 1:101 W. OAKTON STREET
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60018
Practice Address - Country:US
Practice Address - Phone:847-803-0181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-03
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051300472183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist