| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JESSICA TRADER | 1699379560 | 2020-11-22 |
Jessica Trader is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1699379560. Registration indicates Jessica Trader is a provider of services with a specialization in Pharmacy Service Providers, Pharmacist (Pharmacist, ) (Pharmacist, Pharmacy Service Providers)
| Entity Type | Individual |
| Provider Name | Jessica Trader PHARMD |
| Practice Office Address | 534 WOODLAWN RD LINCOLN, IL US |
| Practice Office Telephone | 2177351548 |
| Practice Office Fax | 2177352578 |
| Mailing Address | 534 WOODLAWN RD LINCOLN, IL 626561405 US |
| Business Telephone | 2177351548 |
| Business Fax | 2177352578 |
| Code | Practice | License No State |
|---|---|---|
| 183500000X PRIMARY | Pharmacy Service Providers Pharmacist Pharmacist Pharmacist Pharmacy Service Providers | 051298611
IL |