Provider Demographics
NPI:1023388766
Name:RAUBER, JEFFREY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:
Last Name:RAUBER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 PRAIRIE AVE
Mailing Address - Street 2:
Mailing Address - City:BELOIT
Mailing Address - State:WI
Mailing Address - Zip Code:53511-3133
Mailing Address - Country:US
Mailing Address - Phone:608-365-2001
Mailing Address - Fax:608-365-3786
Practice Address - Street 1:1901 PRAIRIE AVE
Practice Address - Street 2:
Practice Address - City:BELOIT
Practice Address - State:WI
Practice Address - Zip Code:53511-3133
Practice Address - Country:US
Practice Address - Phone:608-365-2001
Practice Address - Fax:608-365-3786
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-11
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-294690183500000X
WI16200-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist