Provider Demographics
NPI:1578948196
Name:VILLARREAL, OSWALDO JR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:OSWALDO
Middle Name:
Last Name:VILLARREAL
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 1:471 ANTHONY TRL
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2535
Mailing Address - Country:US
Mailing Address - Phone:847-293-7102
Mailing Address - Fax:
Practice Address - Street 1:1050 WAUKEGAN RD
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-3700
Practice Address - Country:US
Practice Address - Phone:847-272-3155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-24
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051298678183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist