Provider Demographics
NPI:1558485516
Name:STERES, STEWART (RPH)
Entity Type:Individual
Prefix:MR
First Name:STEWART
Middle Name:
Last Name:STERES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:952 THOMPSON BLVD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-1018
Mailing Address - Country:US
Mailing Address - Phone:847-634-3752
Mailing Address - Fax:
Practice Address - Street 1:290 HAWTHORN VILLAGE COMMONS
Practice Address - Street 2:
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1519
Practice Address - Country:US
Practice Address - Phone:847-918-9626
Practice Address - Fax:847-247-0946
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist