Provider Demographics
NPI:1861772451
Name:STEDMAN, RICHARD R (PHARM D)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:R
Last Name:STEDMAN
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 1:101 LILY CACHE LN
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4895
Mailing Address - Country:US
Mailing Address - Phone:630-759-3011
Mailing Address - Fax:630-759-5329
Practice Address - Street 1:101 LILY CACHE LN
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-4895
Practice Address - Country:US
Practice Address - Phone:630-759-3011
Practice Address - Fax:630-759-5329
Is Sole Proprietor?:No
Enumeration Date:2011-08-26
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051287343183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist