Provider Demographics
NPI:1386091106
Name:INCROCCI, DENISA
Entity type:Individual
Prefix:MRS
First Name:DENISA
Middle Name:
Last Name:INCROCCI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DENISA
Other - Middle Name:
Other - Last Name:GIANNETTO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:33 S PLUM GROVE RD
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-6242
Mailing Address - Country:US
Mailing Address - Phone:847-358-1202
Mailing Address - Fax:847-358-9976
Practice Address - Street 1:33 S PLUM GROVE RD
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-6242
Practice Address - Country:US
Practice Address - Phone:847-358-1200
Practice Address - Fax:847-258-9976
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-23
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051037013183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist