Individual
KATHLEEN SUE JACOBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.PH.
Contact information
Practice address
3132 OLD JACKSONVILLE RD, SPRINGFIELD, IL 62704-7400
(217) 862-0001
(217) 862-0003
Mailing address
1808 BLUE STONE DR, SPRINGFIELD, IL 62704-8719
(217) 793-0129
(217) 862-0001
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
—
IL
Other
Enumeration date
10/22/2007
Last updated
10/22/2007
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