Provider Demographics
NPI:1568747509
Name:DAVILA, HECTOR C JR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:C
Last Name:DAVILA
Suffix:JR
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 1:63 W 87TH ST
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-2200
Mailing Address - Country:US
Mailing Address - Phone:630-778-7645
Mailing Address - Fax:630-778-1289
Practice Address - Street 1:63 W 87TH ST
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60565-2200
Practice Address - Country:US
Practice Address - Phone:630-778-7645
Practice Address - Fax:630-778-1289
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.290756183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist