Provider Demographics
NPI:1639527658
Name:ARNOLD, RENEE (RPH)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:ARNOLD
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 1:1403 W JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-6701
Mailing Address - Country:US
Mailing Address - Phone:815-725-1290
Mailing Address - Fax:815-725-7926
Practice Address - Street 1:1403 W JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-6701
Practice Address - Country:US
Practice Address - Phone:815-725-1290
Practice Address - Fax:815-725-7926
Is Sole Proprietor?:No
Enumeration Date:2016-05-31
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0510398081835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care