Provider Demographics
NPI:1316286321
Name:REYES, ANTHONY J (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:J
Last Name:REYES
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:127 E OGDEN AVE
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-3154
Mailing Address - Country:US
Mailing Address - Phone:630-357-1040
Mailing Address - Fax:630-357-1431
Practice Address - Street 1:1200 W BOUGHTON RD
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-6568
Practice Address - Country:US
Practice Address - Phone:630-759-1362
Practice Address - Fax:630-759-2260
Is Sole Proprietor?:No
Enumeration Date:2013-02-11
Last Update Date:2021-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051293863183500000X
IN26023502A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist