Provider Demographics
NPI:1548542939
Name:HESS, HAROLD CONRAD (PHARMD)
Entity type:Individual
Prefix:MR
First Name:HAROLD
Middle Name:CONRAD
Last Name:HESS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 W WILSON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-5416
Mailing Address - Country:US
Mailing Address - Phone:773-907-8995
Mailing Address - Fax:
Practice Address - Street 1:3900 FOUNTAIN SQUARE PL
Practice Address - Street 2:
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60085-5416
Practice Address - Country:US
Practice Address - Phone:847-473-2487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.294406183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist