Provider Demographics
NPI:1336425925
Name:SANCHEZ, ROBERT JR (RPH)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:SANCHEZ
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 GOVERNORS DR
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IL
Mailing Address - Zip Code:62634-6092
Mailing Address - Country:US
Mailing Address - Phone:217-947-2098
Mailing Address - Fax:
Practice Address - Street 1:3400 FREEDOM DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62704-6516
Practice Address - Country:US
Practice Address - Phone:217-726-0177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-039886183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist