Provider Demographics
NPI:1821311457
Name:STANLEY, JAMES ROBERT (PHARMD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ROBERT
Last Name:STANLEY
Suffix:
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 1:1771 W DIEHL RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-1828
Mailing Address - Country:US
Mailing Address - Phone:630-799-1595
Mailing Address - Fax:
Practice Address - Street 1:1771 W DIEHL RD
Practice Address - Street 2:SUITE 300
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-1828
Practice Address - Country:US
Practice Address - Phone:630-799-1595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-10
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.293578183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist