Individual
DR. JEWEL SOPHIA YOUNGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, MAT, PHARMD, RPH
Contact information
Practice address
10900 S DOTY AVE, CHICAGO, IL 60628-3804
(773) 344-9061
Mailing address
5208 S DREXEL AVE APT 2W, CHICAGO, IL 60615-3722
(312) 218-6808
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051300661
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051300661
STATE LICENSE NUMBER
IL
Enumeration date
12/27/2017
Last updated
06/16/2018
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