Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACOB FREDERICKS
Active Sole ProprietorJACOB FREDERICKS is a Pharmacist healthcare provider located in SPRINGFIELD, Illinois. NPI 1356066120 is currently active in the NPPES registry. Verify at CMS.
Pharmacist · SPRINGFIELD, IL
Registration Details
- NPI Number
- 1356066120
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 5, 2022 (3.8763239734271 yrs)
- Last Updated
- Oct 5, 2022
- License
-
051.304276 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
3100 S MACARTHUR BLVDSPRINGFIELD, IL, 627045800Browse IL providers · Browse ZIP 62704
- Phone
- 2175284926
- Primary Specialty
-
Pharmacist
183500000X
Other Pharmacist Providers in SPRINGFIELD, IL
| Name | Credential | NPI |
|---|---|---|
| MR. GARTH KYLE REYNOLDS | RPH | 1902895873 |
| RONALD W. GOTTRICH | R.PH., M.S. | 1174557730 |
| MR. QUIN C. HOSTETLER | R.PH. | 1639289846 |
| STARLIN ANN HAYDON-GREATTING | R.PH. | 1447392824 |
| MR. HARRY J BURGE JR. | — | 1932311388 |
| MRS. SUSAN JANE JOHNSON | RPH | 1285839589 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.