Provider Demographics
NPI:1831304039
Name:HARMON, JEFF (RPH)
Entity Type:Individual
Prefix:MR
First Name:JEFF
Middle Name:
Last Name:HARMON
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 1:1053 CHADWICK DR
Mailing Address - Street 2:
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-3361
Mailing Address - Country:US
Mailing Address - Phone:847-548-1486
Mailing Address - Fax:
Practice Address - Street 1:3124 N LEWIS AVE
Practice Address - Street 2:
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60087-2231
Practice Address - Country:US
Practice Address - Phone:847-336-1300
Practice Address - Fax:847-336-0588
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist