Provider Demographics
NPI:1114212727
Name:THOMPSON, ASHLEY ANN (RPH)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ANN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 PLAINFIELD RD
Mailing Address - Street 2:T-0894
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-1166
Mailing Address - Country:US
Mailing Address - Phone:815-439-6950
Mailing Address - Fax:815-439-6950
Practice Address - Street 1:2701 PLAINFIELD RD
Practice Address - Street 2:T-0894
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-1166
Practice Address - Country:US
Practice Address - Phone:815-439-6950
Practice Address - Fax:815-439-6950
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-10
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.293712183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist