Provider Demographics
NPI:1366539066
Name:MACHAJ, DUANE E (RPH)
Entity type:Individual
Prefix:MR
First Name:DUANE
Middle Name:E
Last Name:MACHAJ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:900 S DAMEN AVE
Mailing Address - Street 2:PHARMACY 119
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3730
Mailing Address - Country:US
Mailing Address - Phone:312-569-6131
Mailing Address - Fax:312-569-8812
Practice Address - Street 1:900 S DAMEN AVE
Practice Address - Street 2:PHARMACY 119
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3730
Practice Address - Country:US
Practice Address - Phone:312-569-6131
Practice Address - Fax:312-569-8812
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist