Provider Demographics
NPI:1013186394
Name:LESTER, PATRICK ALAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:ALAN
Last Name:LESTER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 WASHINGTON
Mailing Address - Street 2:
Mailing Address - City:PROPHETSTOWN
Mailing Address - State:IL
Mailing Address - Zip Code:61277
Mailing Address - Country:US
Mailing Address - Phone:815-537-2400
Mailing Address - Fax:815-537-2404
Practice Address - Street 1:316 WASHINGTON
Practice Address - Street 2:
Practice Address - City:PROPHETSTOWN
Practice Address - State:IL
Practice Address - Zip Code:61277
Practice Address - Country:US
Practice Address - Phone:815-537-2400
Practice Address - Fax:815-537-2404
Is Sole Proprietor?:No
Enumeration Date:2008-02-21
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20588183500000X
IL051292160183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA20588OtherPHARMACIST