Provider Demographics
NPI:1306594676
Name:PLESKOVITCH, JULIE (RPH)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:PLESKOVITCH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1651 MIDTOWN RD
Mailing Address - Street 2:
Mailing Address - City:PERU
Mailing Address - State:IL
Mailing Address - Zip Code:61354-1267
Mailing Address - Country:US
Mailing Address - Phone:815-223-4276
Mailing Address - Fax:815-223-4957
Practice Address - Street 1:1651 MIDTOWN RD
Practice Address - Street 2:
Practice Address - City:PERU
Practice Address - State:IL
Practice Address - Zip Code:61354-1267
Practice Address - Country:US
Practice Address - Phone:815-223-4276
Practice Address - Fax:815-223-4957
Is Sole Proprietor?:No
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051039043183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist