Individual
CHRISTOPHER JACOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
300 N MAIN ST, EAST PEORIA, IL 61611-2081
(309) 694-7661
Mailing address
503 NORTHWESTERN ST, SPRING VALLEY, IL 61362-1013
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051302501
IL
Other
Enumeration date
06/24/2020
Last updated
06/24/2020
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