Provider Demographics
NPI:1205173689
Name:OWEN, JOSEPH WILLIAM (PHARMD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:WILLIAM
Last Name:OWEN
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 1:1976 RAYMOND DR
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-6715
Mailing Address - Country:US
Mailing Address - Phone:888-892-7607
Mailing Address - Fax:224-235-4516
Practice Address - Street 1:1976 RAYMOND DR
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-6715
Practice Address - Country:US
Practice Address - Phone:888-892-7607
Practice Address - Fax:224-235-4516
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-06
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26022795A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist