MR. MARK NORMAN GRAVDAL (NPI# 1780988535) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780988535 |
| Entity Type | Individual |
| Full Name | MR. MARK NORMAN GRAVDAL |
| Credential | R.PH., CGP |
| Practice Address |
297 Cascade Dr Crystal Lake IL 60012-3345 |
| Practice Telephone | 8154798363 |
| Mailing Telephone | 8154798363 |
| Enumeration Date | 2011-01-07 |
| Last Update Date | 2011-01-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835G0303X |
Pharmacist Specialization: Geriatric |
051030001 | IL | Pharmacy Service Providers |
| Street Address |
297 CASCADE DR |
| City | CRYSTAL LAKE |
| State | IL |
| Zip Code | 60012-3345 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033574629 | Joan M Ryan | Counselor | 610 N Route 31, Suite E, Crystal Lake, IL 60012 | 2015-12-23 |
| 1285972331 | Lauren Elyse Westerman | Physical Therapist | 1000 Brighton Ln, Crystal Lake, IL 60012 | 2013-01-24 |
| 1447537469 | Sean Gale | Pharmacist | 135 Carmella Dr, Crystal Lake, IL 60012 | 2011-11-04 |
| 1477836625 | Judy Meekyung Fakhouri | Pharmacist | 315 N. Route 31, Crystal Lake, IL 60012 | 2011-09-23 |
| 1730462136 | Leslie Dawn Weckerlin | Pharmacist | 315 N Route 31, Crystal Lake, IL 60012 | 2011-09-21 |
| 1639452188 | Laura Jean Galles | Pharmacist | 315 N. Routet 31, Crystal Lake, IL 60012 | 2011-09-21 |
| 1326320516 | Stacey Jean Knuth | Pharmacist | 315 North Route 31, Crystal Lake, IL 60012 | 2011-09-13 |
| 1356469803 | Donn Orien Humphries | Chiropractor | 690 N Route 31, Suite F, Crystal Lake, IL 60012 | 2007-03-26 |
| 1538204508 | Midwest Physical Therapy Ctr | Clinic/Center | 630 N Rt 31, Suite 103, Crystal Lake, IL 60012 | 2007-02-20 |
| 1356488415 | Charlotte Joy Parcels | Social Worker | 8600 Route 14, Suite 110, Crystal Lake, IL 60012 | 2007-01-30 |
| Find all providers in zip 60012 | ||||
| Taxonomy Code | 1835G0303X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Geriatric |
| A pharmacist who is certified in geriatric pharmacy practice is designated as a "Certified Geriatric Pharmacist" (CGP). To become certified, candidates are expected to be knowledgeable about principles of geriatric pharmacotherapy and the provision of pharmaceutical care to the elderly. |
| Notes: Source: Commission for Certification in Geriatric Pharmacy (www.ccgp.org) [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336702125 | Edgar Auf Dem Graben | Pharmacist | 100 N River Rd Ste G122, Des Plaines, IL 60016-1209 | 2019-04-17 |
| 1467969402 | Hilda Dolapo Hassan | Pharmacist | 2937 Shetland Ln, Montgomery, IL 60538-4104 | 2017-12-29 |
| 1578999348 | Ihuoma C Ozoh | Pharmacist | 18331 Mulberry Terrace, Country Club Hills, IL 60478 | 2013-09-24 |
| 1649619016 | Joel Jay Meyers | Pharmacist | 3107 W Jerome St, Chicago, IL 60645-1142 | 2013-06-19 |
| 1902249790 | Alfredo Villasenor | Pharmacist | 233 Berkshire Dr, Lake Villa, IL 60046-5051 | 2013-04-10 |
| 1730446881 | Bhupendra S Vyas | Pharmacist | 8001 N. Lincoln Ave # 800, C/o Rph On The Go Suite 800, Skokie, IL 60077 | 2012-04-13 |
| 1679848618 | Mark Sly | Pharmacist | 403 N Veterans Pkwy, Bloomington, IL 61704-7718 | 2012-03-08 |
| 1346521333 | Chhaya Patel | Pharmacist | 728 S Taylor Ave, Oak Park, IL 60304-1624 | 2011-09-02 |
| 1972827293 | Cindy Sue Porter | Pharmacist | 2150 N Lincoln Park W, #1411, Chicago, IL 60614-4652 | 2010-03-15 |
| 1104073600 | Rubin B Shah | Pharmacist | 10631 Grandview Dr, Palos Park, IL 60464-2580 | 2008-08-26 |
| Find all providers with the same taxonomy | ||||
| City | CRYSTAL LAKE |
| Zip Code | 60012 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.