Provider Demographics
NPI:1093853087
Name:VELK, JOHN RALPH (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:RALPH
Last Name:VELK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 W SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:VILLA PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60181-2543
Mailing Address - Country:US
Mailing Address - Phone:630-530-1919
Mailing Address - Fax:
Practice Address - Street 1:50 E NORTH AVE
Practice Address - Street 2:TARGET 957 PHARMACY
Practice Address - City:VILLA PARK
Practice Address - State:IL
Practice Address - Zip Code:60181-2543
Practice Address - Country:US
Practice Address - Phone:630-833-7461
Practice Address - Fax:630-833-7461
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist