NPI 1013311299

Tamara Petrovich, PHARMD

Practitioner Pharmacist Champaign, IL

Practice location

Address: 841 Bloomington Rd, Champaign, IL 61820-2101
Phone: (217) 356-4827
Mailing address: 509 W University Ave, Champaign, IL 61820-8827

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 051.289205 (IL)

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Registry record

NPI: 1013311299
Entity type: Individual
Sex (as registered): Female
NPI issued: 16 Oct 2014
Record last updated: 16 Oct 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.