Provider Demographics
NPI:1225319882
Name:HILSENBECK, JAMES E (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:E
Last Name:HILSENBECK
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 1:2100 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-3693
Mailing Address - Country:US
Mailing Address - Phone:630-262-0970
Mailing Address - Fax:630-262-0974
Practice Address - Street 1:2100 W STATE ST
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-3693
Practice Address - Country:US
Practice Address - Phone:630-262-0970
Practice Address - Fax:630-262-0974
Is Sole Proprietor?:No
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051033854183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL051033854OtherRPH LICENSE