Provider Demographics
NPI:1437134459
Name:SOMMERS HANSON, JUDITH BARBARA (PHARMD,CDM)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:BARBARA
Last Name:SOMMERS HANSON
Suffix:
Gender:F
Credentials:PHARMD,CDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 JORIE BLVD
Mailing Address - Street 2:MS 3700
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-4425
Mailing Address - Country:US
Mailing Address - Phone:630-891-5168
Mailing Address - Fax:630-891-5170
Practice Address - Street 1:711 JORIE BLVD
Practice Address - Street 2:MS 3700
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-4425
Practice Address - Country:US
Practice Address - Phone:630-891-5168
Practice Address - Fax:630-891-5170
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO044236183500000X
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist