Provider Demographics
NPI:1649067083
Name:VILJOEN, WILLEM GERHARDUS (RPH)
Entity type:Individual
Prefix:MR
First Name:WILLEM
Middle Name:GERHARDUS
Last Name:VILJOEN
Suffix:
Gender:
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 JOAN ROSE CT
Mailing Address - Street 2:
Mailing Address - City:LE CLAIRE
Mailing Address - State:IA
Mailing Address - Zip Code:52753-0010
Mailing Address - Country:US
Mailing Address - Phone:816-529-2382
Mailing Address - Fax:
Practice Address - Street 1:2010 1ST STREET A
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-7728
Practice Address - Country:US
Practice Address - Phone:309-797-0558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.306767183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist