Provider Demographics
NPI:1841676640
Name:TLAHUETL-PEREZ, NAYELI (RPH PHARM D)
Entity type:Individual
Prefix:DR
First Name:NAYELI
Middle Name:
Last Name:TLAHUETL-PEREZ
Suffix:
Gender:F
Credentials:RPH PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:459 BLACKHAWK AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-2911
Mailing Address - Country:US
Mailing Address - Phone:331-425-9646
Mailing Address - Fax:
Practice Address - Street 1:459 BLACKHAWK AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-2911
Practice Address - Country:US
Practice Address - Phone:331-425-9646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-04
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.298638183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist