Healthcare Provider Details

I. General information

NPI: 1346845518
Provider Name (Legal Business Name): JAIME POLLMANN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2020
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 W MAIN ST
MARION IL
62959-1188
US

IV. Provider business mailing address

1171 FRANKLIN ST
CARLYLE IL
62231-1835
US

V. Phone/Fax

Practice location:
  • Phone: 618-993-4113
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number051290357
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: