Provider Demographics
NPI:1003410309
Name:THOMAS, ASHLEY N (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:N
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 S WATER ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60481-1671
Mailing Address - Country:US
Mailing Address - Phone:815-476-2131
Mailing Address - Fax:815-476-2142
Practice Address - Street 1:1101 S WATER ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:IL
Practice Address - Zip Code:60481-1671
Practice Address - Country:US
Practice Address - Phone:815-476-2131
Practice Address - Fax:815-476-2142
Is Sole Proprietor?:No
Enumeration Date:2020-11-26
Last Update Date:2020-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.294411183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist