Individual
JACOB JAMES LUCKHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2101 W JEFFERSON ST, JOLIET, IL 60435-6621
(815) 730-3867
Mailing address
2101 W JEFFERSON ST, JOLIET, IL 60435-6621
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051.290897
IL
Other
Enumeration date
11/03/2011
Last updated
11/03/2011
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