Provider Demographics
NPI:1053448944
Name:KINSCHERFF, JAMES EDWARD (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:EDWARD
Last Name:KINSCHERFF
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1512 S WEST AVE
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:IL
Mailing Address - Zip Code:61032-6702
Mailing Address - Country:US
Mailing Address - Phone:815-297-0881
Mailing Address - Fax:815-297-0972
Practice Address - Street 1:1512 S WEST AVE
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:IL
Practice Address - Zip Code:61032-6702
Practice Address - Country:US
Practice Address - Phone:815-297-0881
Practice Address - Fax:816-297-0972
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI12115183500000X
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist