Healthcare Provider Details

I. General information

NPI: 1497681787
Provider Name (Legal Business Name): JEANNE LAURETTE VAN HOVELN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 E JONES ST
MILFORD IL
60953-1047
US

IV. Provider business mailing address

1883 E 1200 NORTH RD
MILFORD IL
60953-6262
US

V. Phone/Fax

Practice location:
  • Phone: 815-889-4326
  • Fax: 815-889-4326
Mailing address:
  • Phone: 815-216-6256
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051039078
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: