Provider Demographics
NPI:1316165210
Name:MENSIK, ANTHONY M (RPH)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:M
Last Name:MENSIK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 YELLOWSTONE PKWY
Mailing Address - Street 2:
Mailing Address - City:ALGONQUIN
Mailing Address - State:IL
Mailing Address - Zip Code:60102-5422
Mailing Address - Country:US
Mailing Address - Phone:847-458-8160
Mailing Address - Fax:
Practice Address - Street 1:2000 N RICHMOND RD
Practice Address - Street 2:
Practice Address - City:MCHENRY
Practice Address - State:IL
Practice Address - Zip Code:60050-1419
Practice Address - Country:US
Practice Address - Phone:815-344-8340
Practice Address - Fax:815-344-8374
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist