Individual
MR. JEFFRY RICHARD ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
142 INDIAN SPRINGS DR, SANDWICH, IL 60548-1902
(815) 786-2300
(815) 786-2311
Mailing address
1175 LADY BIRD DR, SOMONAUK, IL 60552-9627
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051.030682
IL
Other
Enumeration date
06/09/2006
Last updated
12/07/2009
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