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General NPI Number Information
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NPI Number | 1861772451
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Entity Type | Individual
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Provider Name | RICHARD R STEDMAN PHARM D.
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Gender | Male
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Dates
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Enumeration Date | 08/26/2011
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Last Update Date | 08/26/2011
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Provider Practice Location Address
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Address Line | 101 LILY CACHE LN
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City | BOLINGBROOK
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State | IL
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Zip | 60440-4895
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Country | US
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Telephone | 630-759-3011
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Fax | 630-759-5329
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Provider Business Mailing Address
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Address Line | 101 LILY CACHE LN
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City | BOLINGBROOK
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State | IL
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Zip | 60440-4895
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Country | US
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Telephone | 630-759-3011
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Fax | 630-759-5329
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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 | 051287343
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License Number State | IL
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