Provider Demographics
NPI:1588873228
Name:SAUER, CHARLES WILLIAM (RPH)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:WILLIAM
Last Name:SAUER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:SYCAMORE
Mailing Address - State:IL
Mailing Address - Zip Code:60178-1341
Mailing Address - Country:US
Mailing Address - Phone:815-762-9599
Mailing Address - Fax:
Practice Address - Street 1:617 W STATE ST
Practice Address - Street 2:
Practice Address - City:SYCAMORE
Practice Address - State:IL
Practice Address - Zip Code:60178-1341
Practice Address - Country:US
Practice Address - Phone:815-762-9599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051337851835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy