Provider Demographics
NPI:1477834802
Name:LAWLEY, TONI MARIE (RPH)
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:MARIE
Last Name:LAWLEY
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 1:314 S MCCOY ST
Mailing Address - Street 2:
Mailing Address - City:GRANVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61326-9333
Mailing Address - Country:US
Mailing Address - Phone:815-339-2286
Mailing Address - Fax:815-339-2288
Practice Address - Street 1:314 S MCCOY ST
Practice Address - Street 2:
Practice Address - City:GRANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61326-9333
Practice Address - Country:US
Practice Address - Phone:815-339-2286
Practice Address - Fax:815-339-2288
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.290865183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist