Brian Louis Raymond, PHARM. D.
Individual provider Active NPI Pharmacist · Broadview, IL
NPI 1962798181 · NPPES record last updated Jun 27, 2011
Key facts
- NPI
- 1962798181
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 051.289162 (IL)
- Practice address
- 800 Broadview Village SQ
D145
Broadview, IL 60155-4887 - Phone
- (847) 942-7412
- NPI assigned
- Jun 27, 2011
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 051.289162 | IL | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051.289162 | IL | Yes |
Addresses
Primary practice location
800 Broadview Village SQ
D145
Broadview, IL 60155-4887
Mailing address
800 Broadview Village SQ
D145
Broadview, IL 60155-4887
Phone (847) 942-7412
Other providers in Broadview, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 27, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.