Provider Demographics
NPI:1275957433
Name:LUDWIG, DENNIS (PHARMD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:LUDWIG
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 1:761 W BAUER RD
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-1104
Mailing Address - Country:US
Mailing Address - Phone:630-637-1097
Mailing Address - Fax:
Practice Address - Street 1:761 W BAUER RD
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-1104
Practice Address - Country:US
Practice Address - Phone:630-637-1097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-09
Last Update Date:2014-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051033063183500000X
NE8702183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist