Provider Demographics
NPI:1164022547
Name:WEEKS, TRENT RYAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TRENT
Middle Name:RYAN
Last Name:WEEKS
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 1:2245 KINGSMILL ST
Mailing Address - Street 2:
Mailing Address - City:YORKVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60560-9062
Mailing Address - Country:US
Mailing Address - Phone:630-362-5837
Mailing Address - Fax:
Practice Address - Street 1:2415 N BLOOMINGTON ST
Practice Address - Street 2:
Practice Address - City:STREATOR
Practice Address - State:IL
Practice Address - Zip Code:61364-1305
Practice Address - Country:US
Practice Address - Phone:815-672-3517
Practice Address - Fax:815-672-3719
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.294425183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist