Healthcare Provider Details

I. General information

NPI: 1760762371
Provider Name (Legal Business Name): MRS. JEAN YEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2011
Last Update Date: 08/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2986 KIRK RD
AURORA IL
60502-6000
US

IV. Provider business mailing address

2986 KIRK RD
AURORA IL
60502-6000
US

V. Phone/Fax

Practice location:
  • Phone: 630-375-0570
  • Fax: 630-375-0943
Mailing address:
  • Phone: 630-375-0570
  • Fax: 630-375-0943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051.288791
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: