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General NPI Number Information
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NPI Number | 1649473547
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Entity Type | Individual
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Provider Name | ALLISON BRADEN PHARM.D
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Gender | Female
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 10/01/2013
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Provider Practice Location Address
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Address Line | 1400 W PARK ST
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City | URBANA
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State | IL
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Zip | 61801-2334
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Country | US
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Telephone | 217-337-2700
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Fax |
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Provider Business Mailing Address
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Address Line | 105 BRADFORD AVE
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City | SAVOY
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State | IL
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Zip | 61874-9346
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Country | US
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Telephone | 217-552-2120
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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 | 23896
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 051294060
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2009013475
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License Number State | MO
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