Provider Demographics
NPI:1649882333
Name:NONO, ONYANGO (PHARMACIST)
Entity type:Individual
Prefix:DR
First Name:ONYANGO
Middle Name:
Last Name:NONO
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15940 KEDZIE AVE
Mailing Address - Street 2:
Mailing Address - City:MARKHAM
Mailing Address - State:IL
Mailing Address - Zip Code:60428-4017
Mailing Address - Country:US
Mailing Address - Phone:708-339-1184
Mailing Address - Fax:
Practice Address - Street 1:15940 KEDZIE AVE
Practice Address - Street 2:
Practice Address - City:MARKHAM
Practice Address - State:IL
Practice Address - Zip Code:60428-4017
Practice Address - Country:US
Practice Address - Phone:708-339-1184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-23
Last Update Date:2020-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.3000313183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist