Ryan Michael Taylor, PHARMD

Individual provider Active NPI Pharmacist · Germantown Hills, IL

NPI 1154553790 · NPPES record last updated Aug 16, 2009

Key facts

NPI
1154553790
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
051288433 (IL)
Practice address
209 Jerry Ave
Germantown Hills, IL 61548-9262
Phone
(309) 383-2301
NPI assigned
Aug 16, 2009
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
051288433ILMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051288433 IL Yes

Addresses

Primary practice location

209 Jerry Ave
Germantown Hills, IL 61548-9262

Mailing address

209 Jerry Ave
Germantown Hills, IL 61548-9262
Phone (309) 383-2301

Other providers in Germantown Hills, IL

All providers in Germantown Hills, IL · Pharmacist in Illinois

Sources for this page

Verify at the official NPI Registry.