MEDICARE: FRANK A THAYER JR. RPH

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	051040220	IL

General Provider Information

NPI Number	:	1972228914
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANK A THAYER JR. RPH

Provider Business Mailing Address
First Line	:	25849 DEER RUN
Second Line	:
City	:	STERLING
State	:	IL
Zip	:	61081-7800
Country	:	US
Telephone Number	:	815-499-5647
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 PINES RD
Second Line	:
City	:	OREGON
State	:	IL
Zip	:	61061-9653
Country	:	US
Telephone Number	:	815-732-1422
Fax Number	:

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

Provider Enumeration Date	:	10/11/2022
Last Update Date	:	10/11/2022

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Directions to “ FRANK A THAYER JR. RPH” Practice Location

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