Provider Demographics
NPI:1649629296
Name:RITTNER, ERIC
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:RITTNER
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 1:442 E RAND RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-3101
Mailing Address - Country:US
Mailing Address - Phone:847-255-8740
Mailing Address - Fax:847-255-4710
Practice Address - Street 1:442 E RAND RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HTS
Practice Address - State:IL
Practice Address - Zip Code:60004-3101
Practice Address - Country:US
Practice Address - Phone:847-255-8740
Practice Address - Fax:847-255-4710
Is Sole Proprietor?:No
Enumeration Date:2016-06-05
Last Update Date:2016-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051039132183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist