Provider Demographics
NPI:1801001326
Name:DOBBELHOFF, RICHARD L (RPH, CDE, CDM)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:L
Last Name:DOBBELHOFF
Suffix:
Gender:M
Credentials:RPH, CDE, CDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 HILLVIEW RD
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-3415
Mailing Address - Country:US
Mailing Address - Phone:708-798-2075
Mailing Address - Fax:708-799-3667
Practice Address - Street 1:3153 183RD ST
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-2806
Practice Address - Country:US
Practice Address - Phone:708-799-8411
Practice Address - Fax:708-799-8997
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26014272A183500000X
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist