Provider Demographics
NPI:1912500968
Name:PILONES, LEVI KARELL CANETE
Entity Type:Individual
Prefix:
First Name:LEVI KARELL
Middle Name:CANETE
Last Name:PILONES
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 1:8330 HARDING AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-2713
Mailing Address - Country:US
Mailing Address - Phone:773-603-8446
Mailing Address - Fax:
Practice Address - Street 1:3434 DEMPSTER ST
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-2442
Practice Address - Country:US
Practice Address - Phone:847-674-1242
Practice Address - Fax:847-674-1248
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.301443183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist