Provider Demographics
NPI:1093745259
Name:HENEY, COURTNEY M (PHARMACY TECHNICIAN)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:M
Last Name:HENEY
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7032 S CARPENTER ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60621
Mailing Address - Country:US
Mailing Address - Phone:773-814-8510
Mailing Address - Fax:
Practice Address - Street 1:6905 S WENTWORTH AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60621
Practice Address - Country:US
Practice Address - Phone:773-723-2500
Practice Address - Fax:773-723-7828
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician