Provider Demographics
NPI:1902030851
Name:DAL PONTE, ANTHONY J (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:J
Last Name:DAL PONTE
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9534 S ROBERTS RD
Mailing Address - Street 2:
Mailing Address - City:HICKORY HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60457-2239
Mailing Address - Country:US
Mailing Address - Phone:708-598-0564
Mailing Address - Fax:708-598-8684
Practice Address - Street 1:9534 S ROBERTS RD
Practice Address - Street 2:
Practice Address - City:HICKORY HILLS
Practice Address - State:IL
Practice Address - Zip Code:60457-2239
Practice Address - Country:US
Practice Address - Phone:708-598-0564
Practice Address - Fax:708-598-8684
Is Sole Proprietor?:No
Enumeration Date:2009-05-06
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.290067183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist