Individual
MRS. JANE MARGARET JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
603 S 4TH ST, CHILLICOTHE, IL 61523-2267
(309) 274-3419
Mailing address
4717 W BRIDALWOOD DR, PEORIA, IL 61615-2707
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051-036315
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051-036315
REGISTERED PHARMACIST
IL
Enumeration date
11/22/2019
Last updated
11/22/2019
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