Provider Demographics
NPI:1144502758
Name:DRAPER, VICKI (RPH)
Entity type:Individual
Prefix:MRS
First Name:VICKI
Middle Name:
Last Name:DRAPER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:PROF
Other - First Name:VICKI
Other - Middle Name:
Other - Last Name:DRAPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17955 WOLF RD
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-9427
Mailing Address - Country:US
Mailing Address - Phone:708-478-3758
Mailing Address - Fax:708-478-4609
Practice Address - Street 1:17955 WOLF RD
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-9427
Practice Address - Country:US
Practice Address - Phone:708-478-3758
Practice Address - Fax:708-478-4609
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051035787183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist