Provider Demographics
NPI:1811083850
Name:WEBER, BONNIE EVA (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:EVA
Last Name:WEBER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1559 E. CHIVALRY CT.
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60074
Mailing Address - Country:US
Mailing Address - Phone:847-271-6706
Mailing Address - Fax:
Practice Address - Street 1:1415 LAKE COOK RD. MS L444
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-5213
Practice Address - Country:US
Practice Address - Phone:847-964-8211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL51291170183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist