Provider Demographics
NPI:1619188224
Name:STEINBRENNER, DENNIS OWEN (RPH)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:OWEN
Last Name:STEINBRENNER
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 1:1202 STATE ST
Mailing Address - Street 2:
Mailing Address - City:LEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60439-4489
Mailing Address - Country:US
Mailing Address - Phone:630-243-1803
Mailing Address - Fax:630-243-1903
Practice Address - Street 1:1202 STATE ST
Practice Address - Street 2:
Practice Address - City:LEMONT
Practice Address - State:IL
Practice Address - Zip Code:60439
Practice Address - Country:US
Practice Address - Phone:630-243-1887
Practice Address - Fax:630-243-1906
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-029262183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL051-029262OtherSTATE OF ILLINOIS DEPARTMENT OF FINANCIAL AND AND PROFESSIONAL REGULATION