Provider Demographics
NPI:1689955379
Name:WARREN, RONALD ANTHONY (RPH)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:ANTHONY
Last Name:WARREN
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 1:2020 S NAPERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-8171
Mailing Address - Country:US
Mailing Address - Phone:630-682-2582
Mailing Address - Fax:630-682-2930
Practice Address - Street 1:2020 S NAPERVILLE RD
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60189-8171
Practice Address - Country:US
Practice Address - Phone:630-682-2582
Practice Address - Fax:630-682-2930
Is Sole Proprietor?:No
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051029687183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist