Individual
JINCY PHILIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1713 W SPRINGFIELD AVE, CHAMPAIGN, IL 61821-3011
(217) 356-2529
Mailing address
1028 E KERR AVE, APT 301, URBANA, IL 61802-9127
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051297260
IL
Other
Enumeration date
05/01/2014
Last updated
05/01/2014
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