| Doctor Name: | MR. MARK ANTHONY GURGONE |
| NPI Number: | 1063502268 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RPH., BCNP |
| License Number: | 051.286647 |
| Business Practice Address: | 161 Tower Dr Unit A Burr Ridge, IL - 605275776 |
| Business Phone Number: | 6303210218 |
| Business Fax Number: | 6303210345 |
| Mailing Address: | 7606 Red Oak Dr, PLAINFIELD |
| State: | IL |
| Postal Code: | 605862510 |
| Phone Number: | 8157824743 |
| Fax Number: | |
| NPI Enumeration Date: | 10/16/2006 |
| NPI Last Update Date: | 01/04/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1835N0905X |
| License Number: | 051.286647 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Pharmacy Service Providers |
| Taxonomy Classification: | Pharmacist |
| Taxonomy Specialization: | Nuclear |
| Taxonomy Definition: | A licensed pharmacist who has demonstrated specialized knowledge and skill in procurement, compounding, quality control testing, dispensing, distribution, and monitoring of radiopharmaceuticals. |