Provider Demographics
NPI:1780288183
Name:QUINONES, RONALD PAUL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:PAUL
Last Name:QUINONES
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17248 SHERWOOD FOREST RD
Mailing Address - Street 2:
Mailing Address - City:HAVANA
Mailing Address - State:IL
Mailing Address - Zip Code:62644-6336
Mailing Address - Country:US
Mailing Address - Phone:309-361-9370
Mailing Address - Fax:
Practice Address - Street 1:201 W MAIN ST
Practice Address - Street 2:
Practice Address - City:HAVANA
Practice Address - State:IL
Practice Address - Zip Code:62644-1137
Practice Address - Country:US
Practice Address - Phone:309-543-2253
Practice Address - Fax:309-543-3471
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-288305183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist