Individual
JACOB THOMAS KOTECKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2399 N BLOOMINGTON ST, STREATOR, IL 61364-1307
(815) 672-6874
Mailing address
2399 N BLOOMINGTON ST, STREATOR, IL 61364-1307
(815) 672-6874
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051.295783
IL
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
051.295783
IL
Other
Enumeration date
11/26/2019
Last updated
06/30/2026
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