Provider Demographics
NPI:1154603280
Name:CONTRERAS, BLANCA L (PHARM D)
Entity type:Individual
Prefix:
First Name:BLANCA
Middle Name:L
Last Name:CONTRERAS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 N WINFIELD SUITE 101
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190
Mailing Address - Country:US
Mailing Address - Phone:630-407-0340
Mailing Address - Fax:630-407-0399
Practice Address - Street 1:25 NORTH WINFIELD ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190
Practice Address - Country:US
Practice Address - Phone:630-407-0340
Practice Address - Fax:630-407-0399
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-288903183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist