Provider Demographics
NPI:1932635174
Name:HUMES, CHRISTOPHER DAVID (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:DAVID
Last Name:HUMES
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 1:3103 RIVERBIRCH DR
Mailing Address - Street 2:APT 112
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60502-7140
Mailing Address - Country:US
Mailing Address - Phone:773-915-3524
Mailing Address - Fax:
Practice Address - Street 1:3103 RIVERBIRCH DR
Practice Address - Street 2:APT 112
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60502-7140
Practice Address - Country:US
Practice Address - Phone:773-915-3524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-09
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.300267183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist