Provider Demographics
NPI:1053691527
Name:HYRCZYK, DAVID M (RPH)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:M
Last Name:HYRCZYK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1378 MINER ST
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-3372
Mailing Address - Country:US
Mailing Address - Phone:847-296-3958
Mailing Address - Fax:847-296-4574
Practice Address - Street 1:1378 MINER ST
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-3372
Practice Address - Country:US
Practice Address - Phone:847-296-3958
Practice Address - Fax:847-296-4574
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-27
Last Update Date:2011-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051034355183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist