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NPI 1780988535

IndividualActive

Mark Gravdal, R.PH., CGP

NPI 1780988535 · Geriatric Pharmacist · Crystal Lake, IL

Provider details

NPI number: 1780988535
Entity type: Individual
Primary specialty: Geriatric PharmacistPharmacy Service Providers
Credential: R.PH., CGP
Sex: Male
Sole proprietor: Yes
License: 051030001 (IL)

Practice location

297 Cascade Dr

Crystal Lake, IL 60012-3345

Phone: (815) 479-8363

More IL providers

Mailing address

297 Cascade Dr

Crystal Lake, IL 60012-3345

Registry dates

Enumerated: 2011-01-07
Last updated: 2011-01-07

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Mark Gravdal, R.PH., CGP — NPI 1780988535, Crystal Lake, IL | NPI Central