Michael Basta
Pharmacist in Oak Lawn, IL. Individual provider (NPI-1).
NPI number1750184511
StatusActive
Last updated in NPPESMar 28, 2025
Details
- NPI
- 1750184511
- Entity type
- Individual (NPI-1)
- Name
- Michael Basta
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 28, 2025
- Certification date
- Mar 28, 2025
- Last updated
- Mar 28, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183500000X | Pharmacist | 051306909 | IL | Yes |
Practice location
10639 S Cicero AveOak Lawn, IL 60453-5269
Phone 708-424-3594
Mailing address
10639 S Cicero AveOak Lawn, IL 60453-5269
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