Provider Demographics
NPI:1295003507
Name:TIMONES, ANGELA (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:
Last Name:TIMONES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MRS
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:CHA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:861 CROSS CREEK DR N
Mailing Address - Street 2:UNIT 2B
Mailing Address - City:ROSELLE
Mailing Address - State:IL
Mailing Address - Zip Code:60172-3694
Mailing Address - Country:US
Mailing Address - Phone:847-414-1506
Mailing Address - Fax:
Practice Address - Street 1:861 CROSS CREEK DR.
Practice Address - Street 2:UNITE 2B
Practice Address - City:ROSELLE
Practice Address - State:IL
Practice Address - Zip Code:60172-3694
Practice Address - Country:US
Practice Address - Phone:847-414-1506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-01
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.292763183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist