Provider Demographics
NPI:1982208062
Name:KLIMEK, JONATHAN ANTHONY (PHARMD)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:ANTHONY
Last Name:KLIMEK
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 1:93 S PINE ST
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-1918
Mailing Address - Country:US
Mailing Address - Phone:708-280-6284
Mailing Address - Fax:
Practice Address - Street 1:400 N COUNTY FARM RD
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-3908
Practice Address - Country:US
Practice Address - Phone:630-784-4275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.294039183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist