Illinois Department of Human
NPI #1255462156 in Springfield, Illinois
Provider Information
- NPI Number
- 1255462156
- Entity Type
- Organization
- Organization Name
- Illinois Department of Human
- Primary Specialty
- Pharmacy - Mail Order Pharmacy
- Enumeration Date
- Mar 9, 2007
- Last Updated
- Feb 11, 2009
Practice Location
- Address
- 901 SOUTHWIND DR
- City
- Springfield
- State
- Illinois
- ZIP Code
- 62703-5125
- Phone
- (217) 558-0965
Authorized Official
- Name
- MARK KATAUSKI
- Title
- DIR OF PHRM
- Phone
- (217) 786-6982
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy - Mail Order Pharmacy — Mail Order Pharmacy |
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