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Theresa Ann Johnson

Pharmacist in Urbana, IL. Individual provider (NPI-1).

NPI number1639770985
StatusActive
Last updated in NPPESNov 3, 2020

Details

NPI
1639770985
Entity type
Individual (NPI-1)
Name
Theresa Ann Johnson
Sex
Female
Sole proprietor
Yes
Enumeration date
Nov 3, 2020
Certification date
Nov 3, 2020
Last updated
Nov 3, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
183500000X Pharmacist051-039192ILYes

Practice location

100 S High Cross Rd
Urbana, IL 61802-7804

Phone 217-390-0273

Mailing address

1734 S Stone Creek Blvd
Urbana, IL 61802-9667

Phone 217-355-7956

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