Individual
JOE BOUDREAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
2610 N PROSPECT AVE, CHAMPAIGN, IL 61822-1251
(217) 352-1490
Mailing address
2610 N PROSPECT AVE, CHAMPAIGN, IL 61822-1251
(217) 352-1490
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051.298005
IL
Other
Enumeration date
11/06/2020
Last updated
11/06/2020
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