Provider Demographics
NPI:1093751315
Name:VARNER, DWIGHT L III (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DWIGHT
Middle Name:L
Last Name:VARNER
Suffix:III
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 1:334 LAKE RUN LN
Mailing Address - Street 2:
Mailing Address - City:NORTH AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60542-6100
Mailing Address - Country:US
Mailing Address - Phone:630-907-2593
Mailing Address - Fax:
Practice Address - Street 1:1221 N LAKE ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-2454
Practice Address - Country:US
Practice Address - Phone:630-264-6269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.289398183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist