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Individual

BRENDAN JAMES SPENCE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
2140 N PEORIA RD, SPRINGFIELD, IL 62702-1840
(217) 544-2925
Mailing address
3441 SMYTHBERRY LN APT 3, SPRINGFIELD, IL 62711-8210
(630) 642-0600

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051.302118
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
051.302118
PHARMACIST LICENSE
IL
Enumeration date
05/07/2020
Last updated
01/03/2023
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