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NPI Code Detail

MEDICARE: DR. JACQUELINE ANDERSON PHARM D

MEDICARE: DR. JACQUELINE ANDERSON PHARM D
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
1183500000XPharmacist051291903IL

General Provider Information

NPI Number : 1982972642
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JACQUELINE ANDERSON PHARM D
Provider Business Mailing Address
First Line : 7209 W LINCOLN HWY
Second Line :
City : FRANKFORT
State : IL
Zip : 60423-6021
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7209 W LINCOLN HWY
Second Line :
City : FRANKFORT
State : IL
Zip : 60423-6021
Country : US
Telephone Number : 815-464-8374
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2011
Last Update Date : 12/09/2011

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Directions to “ DR. JACQUELINE ANDERSON PHARM D” Practice Location

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