Healthcare Provider Details

I. General information

NPI: 1598975005
Provider Name (Legal Business Name): CURTIS BRUCE SHERMAN RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91 KNOXVILLE AVE
BRIMFIELD IL
61517
US

IV. Provider business mailing address

15014 W WINCHESTER DR
BRIMFIELD IL
61517-9319
US

V. Phone/Fax

Practice location:
  • Phone: 309-446-3292
  • Fax: 309-446-9696
Mailing address:
  • Phone: 309-446-9025
  • Fax: 309-446-9696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: