Gravdal, Mark Norman

Gravdal, Mark Norman is an sole proprietor health care provider with primary practice located at 297 Cascade Dr , Crystal Lake IL 60012-3345. He recently has only one registered license in Pharmacy Service Providers / Geriatric, which is considered as his primary health care specialty. Gravdal, Mark Norman can be contacted via phone (815) 479-8363.

Contact Information

Primary practice address
297 Cascade Dr Crystal Lake IL 60012-3345
Phone: (815) 479-8363
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Geriatric 1835G0303X 051030001 Illinois

Profile Details

NPI number 1780988535
LBN Legal business name Gravdal, Mark Norman
Credentials R.PH., CGP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 7th, 2011
Last updated Jan 7th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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