MEDICARE: DR. REBECCA LYNN FEUERBORN PHARM.D, R.PH.

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	:	1659588358
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REBECCA LYNN FEUERBORN PHARM.D, R.PH.

Provider Business Mailing Address
First Line	:	433 ASCOT LN
Second Line	:
City	:	STREAMWOOD
State	:	IL
Zip	:	60107-6641
Country	:	US
Telephone Number	:	630-830-0923
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 N STATE ST
Second Line	:
City	:	MARENGO
State	:	IL
Zip	:	60152-2217
Country	:	US
Telephone Number	:	815-568-7242
Fax Number	:

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

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	07/08/2007

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