Provider Demographics
NPI:1437506235
Name:READ, AMY
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:READ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3795 ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:IL
Mailing Address - Zip Code:60543-5015
Mailing Address - Country:US
Mailing Address - Phone:630-551-2672
Mailing Address - Fax:630-551-7802
Practice Address - Street 1:3795 ORCHARD RD
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:IL
Practice Address - Zip Code:60543-5015
Practice Address - Country:US
Practice Address - Phone:630-551-2672
Practice Address - Fax:630-551-7802
Is Sole Proprietor?:No
Enumeration Date:2016-05-21
Last Update Date:2016-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051288403183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist