Berry, Phyllis Anne
Berry, Phyllis Anne is an individual health care provider with primary practice located at 1757 W Kirby Ave , Champaign IL 61821-5500. She recently has only one registered license in Pharmacy Service Providers / Pharmacotherapy, which is considered as her primary health care specialty. Berry, Phyllis Anne can be contacted via phone (217) 383-3398.Contact Information
Primary practice address
1757 W Kirby Ave
Champaign IL 61821-5500
Phone: (217) 383-3398
Fax: (217) 359-7063
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Pharmacy Service Providers / Pharmacotherapy | 1835P1200X | Illinois |
Profile Details
| NPI number | 1851456248 |
|---|---|
| LBN Legal business name | Berry, Phyllis Anne |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 26th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1851456248 | NPPES |
| Illinois | MEDICAID | 371119538015 |
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