Provider Demographics
NPI:1528349107
Name:KWAK, ROBERT OERIK (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:OERIK
Last Name:KWAK
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 1:940 S FRONTAGE RD STE 1900
Mailing Address - Street 2:
Mailing Address - City:WOODRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60517-5033
Mailing Address - Country:US
Mailing Address - Phone:630-310-1603
Mailing Address - Fax:
Practice Address - Street 1:940 S FRONTAGE RD STE 1900
Practice Address - Street 2:
Practice Address - City:WOODRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60517-5033
Practice Address - Country:US
Practice Address - Phone:630-310-1603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-08
Last Update Date:2021-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0512947311835P1200X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy