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General NPI Number Information
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NPI Number | 1700900297
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Entity Type | Individual
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Provider Name | ANTOINETTE FUNK R.PH.
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Gender | Female
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3116 RT 59
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City | NAPERVILLE
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State | IL
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Zip | 60564
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Country | US
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Telephone | 630-922-1704
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Fax |
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Provider Business Mailing Address
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Address Line | 140 AUTUMN RDG
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City | MONTGOMERY
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State | IL
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Zip | 60538-2934
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Country | US
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Telephone | 630-896-1210
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number |
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License Number State | IL
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