Provider Demographics
NPI:1396989729
Name:RHODEN RHONE, DENISE (RPH)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:RHODEN RHONE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1417 S CAMPUS PKWY
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60608-1033
Mailing Address - Country:US
Mailing Address - Phone:312-265-0427
Mailing Address - Fax:312-265-0428
Practice Address - Street 1:9434 S HALSTED ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60620-2721
Practice Address - Country:US
Practice Address - Phone:773-238-5648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-29
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051037365183500000X
TX29718183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist