Individual
CAROLYNE JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1201 W SPRING ST, SOUTH ELGIN, IL 60177-2990
(847) 695-0556
Mailing address
1604 THORNBURY RD, BARTLETT, IL 60103-2330
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051304663
IL
Other
Enumeration date
05/04/2022
Last updated
05/04/2022
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