Healthcare Provider Details

I. General information

NPI: 1720150923
Provider Name (Legal Business Name): RONALD CAPEK RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 GRANT AVE
GENEVA IL
60134-1114
US

IV. Provider business mailing address

335 GRANT AVE
GENEVA IL
60134-1114
US

V. Phone/Fax

Practice location:
  • Phone: 630-232-8838
  • Fax: 815-562-5079
Mailing address:
  • Phone: 630-232-8838
  • Fax: 815-562-5079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: