Provider Demographics
NPI:1720150923
Name:CAPEK, RONALD (RPH)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:
Last Name:CAPEK
Suffix:
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 1:335 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-1114
Mailing Address - Country:US
Mailing Address - Phone:630-232-8838
Mailing Address - Fax:815-562-5079
Practice Address - Street 1:335 GRANT AVE
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-1114
Practice Address - Country:US
Practice Address - Phone:630-232-8838
Practice Address - Fax:815-562-5079
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist