Individual
DR. JESSICA NICHOLE BERGHAUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1001 N WEST ST, OLNEY, IL 62450-3774
(618) 392-3464
Mailing address
1001 N WEST ST, OLNEY, IL 62450-3774
(618) 392-3464
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051298238
IL
Other
Enumeration date
10/29/2020
Last updated
10/29/2020
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