Provider Demographics
NPI:1932322575
Name:SIIL, DAWN LOUISE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:LOUISE
Last Name:SIIL
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 1:2363 63RD ST
Mailing Address - Street 2:
Mailing Address - City:WOODRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60517-1369
Mailing Address - Country:US
Mailing Address - Phone:630-493-9084
Mailing Address - Fax:
Practice Address - Street 1:2363 63RD ST
Practice Address - Street 2:
Practice Address - City:WOODRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60517-1369
Practice Address - Country:US
Practice Address - Phone:630-493-9084
Practice Address - Fax:630-493-9089
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.035804183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist