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NPI Code Detail

MEDICARE: MICHELLE ELIZABETH JAKAITIS PHARMD

MEDICARE: MICHELLE ELIZABETH JAKAITIS PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist23950IA

General Provider Information

NPI Number : 1326713405
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE ELIZABETH JAKAITIS PHARMD
Provider Business Mailing Address
First Line : 1710 OAK ST
Second Line :
City : QUINCY
State : IL
Zip : 62301-2656
Country : US
Telephone Number : 815-545-6506
Fax Number :
Provider Business Practice Location Address
First Line : 6020 BROADWAY ST
Second Line :
City : QUINCY
State : IL
Zip : 62305-7919
Country : US
Telephone Number : 217-224-3366
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2021
Last Update Date : 03/06/2024

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