Provider Demographics
NPI:1275886848
Name:TOBLER, ANGELA BETH (RPH)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:BETH
Last Name:TOBLER
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 1:222 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WAUCONDA
Mailing Address - State:IL
Mailing Address - Zip Code:60084-1828
Mailing Address - Country:US
Mailing Address - Phone:847-526-2591
Mailing Address - Fax:847-526-1598
Practice Address - Street 1:222 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WAUCONDA
Practice Address - State:IL
Practice Address - Zip Code:60084-1828
Practice Address - Country:US
Practice Address - Phone:847-526-2591
Practice Address - Fax:847-526-1598
Is Sole Proprietor?:No
Enumeration Date:2012-10-19
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051039642183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist