Individual
JACLYN ELIZABETH STAYBACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
2241 WILLOW RD, GLENVIEW, IL 60025-7636
(847) 657-0096
(847) 904-1351
Mailing address
2241 WILLOW RD, GLENVIEW, IL 60025-7636
(847) 657-0096
(847) 904-1351
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051.301052
IL
Other
Enumeration date
11/17/2020
Last updated
11/17/2020
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