Provider Demographics
NPI:1205823283
Name:SOUNHEIN, ALLEN (RPH)
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:
Last Name:SOUNHEIN
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 1:7510 MEADOWSHIRE LN
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60012-2962
Mailing Address - Country:US
Mailing Address - Phone:815-455-1342
Mailing Address - Fax:815-238-5391
Practice Address - Street 1:4100 VETERANS PKWY
Practice Address - Street 2:
Practice Address - City:MCHENRY
Practice Address - State:IL
Practice Address - Zip Code:60050-8350
Practice Address - Country:US
Practice Address - Phone:815-385-6400
Practice Address - Fax:815-385-3910
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist