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General NPI Number Information
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NPI Number | 1306662986
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Entity Type | Individual
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Provider Name | JOHN WOODS
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Gender | Male
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Dates
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Enumeration Date | 11/27/2024
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Last Update Date | 11/27/2024
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Provider Practice Location Address
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Address Line | 2801 CHATHAM RD
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City | SPRINGFIELD
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State | IL
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Zip | 62704-4187
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Country | US
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Telephone | 217-698-3441
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Fax |
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Provider Business Mailing Address
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Address Line | 1893 STONEHEATHER AVE
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City | AURORA
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State | IL
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Zip | 60503-7326
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Country | US
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Telephone | 630-525-1107
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 051.306725
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License Number State | IL
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