Provider Demographics
NPI:1982667176
Name:HIEMENZ, STEVEN PATRICK (RPH,CGP)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:PATRICK
Last Name:HIEMENZ
Suffix:
Gender:M
Credentials:RPH,CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:383 KNOCH KNOLLS RD
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-5408
Mailing Address - Country:US
Mailing Address - Phone:630-983-7187
Mailing Address - Fax:630-420-8236
Practice Address - Street 1:383 KNOCH KNOLLS RD
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60565-5408
Practice Address - Country:US
Practice Address - Phone:630-983-7187
Practice Address - Fax:630-420-8236
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051036352183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist