Provider Demographics
NPI:1003571753
Name:GEORGE, KHAREEMAT OYINDAMOLA (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:KHAREEMAT
Middle Name:OYINDAMOLA
Last Name:GEORGE
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2404 S PERRYVILLE RD
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61108-8231
Mailing Address - Country:US
Mailing Address - Phone:815-332-3256
Mailing Address - Fax:
Practice Address - Street 1:2404 S PERRYVILLE RD
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61108-8231
Practice Address - Country:US
Practice Address - Phone:815-332-3256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-07
Last Update Date:2021-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051304447183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist