Provider Demographics
NPI:1154780682
Name:PEPE, BARBARA ANN (RPH)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:ANN
Last Name:PEPE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:ANN
Other - Last Name:DANIELS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:1045 CRESTWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60175-4806
Mailing Address - Country:US
Mailing Address - Phone:847-809-8539
Mailing Address - Fax:
Practice Address - Street 1:375 RANDALL RD
Practice Address - Street 2:
Practice Address - City:SOUTH ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60177-2248
Practice Address - Country:US
Practice Address - Phone:847-622-1220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-11
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.287439183500000X
PARP035680L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist