Individual
ERIKA DIERICX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
405 W JACKSON ST, CARBONDALE, IL 62901-1462
(185) 490-7216
Mailing address
405 W JACKSON ST, CARBONDALE, IL 62901-1462
(185) 490-7216
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051.298186
IL
Other
Enumeration date
05/01/2018
Last updated
05/01/2018
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