Individual
JAYLA LUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7960 W 159TH ST, ORLAND PARK, IL 60462-5038
(312) 982-3890
Mailing address
4150 CAMBRIDGE DR, COUNTRY CLUB HILLS, IL 60478-7003
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051306000
IL
Other
Enumeration date
11/30/2023
Last updated
11/30/2023
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