Provider Demographics
NPI:1770753451
Name:URNIKIS, ROBERT
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:URNIKIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5TH & ROOSEVELT
Mailing Address - Street 2:BLDG# 37
Mailing Address - City:HINES
Mailing Address - State:IL
Mailing Address - Zip Code:60491-5221
Mailing Address - Country:US
Mailing Address - Phone:708-786-4397
Mailing Address - Fax:708-786-7980
Practice Address - Street 1:5TH & ROOSEVELT
Practice Address - Street 2:BLDG# 37
Practice Address - City:HINES
Practice Address - State:IL
Practice Address - Zip Code:60491-5221
Practice Address - Country:US
Practice Address - Phone:708-786-4397
Practice Address - Fax:708-786-7980
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist