MEDICARE: RICK JOHN ANNES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist		IL

General Provider Information

NPI Number	:	1558481598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICK JOHN ANNES

Provider Business Mailing Address
First Line	:	1816 BROPHY AVE
Second Line	:
City	:	PARK RIDGE
State	:	IL
Zip	:	60068-5202
Country	:	US
Telephone Number	:	847-692-4235
Fax Number	:

Provider Business Practice Location Address
First Line	:	1816 BROPHY AVE
Second Line	:
City	:	PARK RIDGE
State	:	IL
Zip	:	60068-5202
Country	:	US
Telephone Number	:	847-692-4235
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2007
Last Update Date	:	07/08/2007

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Directions to “ RICK JOHN ANNES ” Practice Location

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