Provider Demographics
NPI:1386912210
Name:MARKLEY, PATRICK ANTHONY (BS RPH)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:ANTHONY
Last Name:MARKLEY
Suffix:
Gender:M
Credentials:BS RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 W CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:SANDWICH
Mailing Address - State:IL
Mailing Address - Zip Code:60548-2106
Mailing Address - Country:US
Mailing Address - Phone:815-498-3733
Mailing Address - Fax:
Practice Address - Street 1:30 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:SANDWICH
Practice Address - State:IL
Practice Address - Zip Code:60548-2106
Practice Address - Country:US
Practice Address - Phone:815-498-3733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-07
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL05133687183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist