Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. MARK NORMAN GRAVDAL, R.PH., CGP
Active Sole ProprietorMR. MARK NORMAN GRAVDAL, R.PH., CGP is a Geriatric Pharmacist healthcare provider located in CRYSTAL LAKE, Illinois. NPI 1780988535 is currently active in the NPPES registry. Verify at CMS.
Geriatric Pharmacist · CRYSTAL LAKE, IL
Registration Details
- NPI Number
- 1780988535
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 7, 2011 (15.615191759306 yrs)
- Last Updated
- Jan 7, 2011
- License
-
051030001 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
297 CASCADE DRCRYSTAL LAKE, IL, 600123345Browse IL providers · Browse ZIP 60012
- Phone
- 8154798363
- Primary Specialty
-
Geriatric Pharmacist
1835G0303X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.