Provider Demographics
NPI:1245767003
Name:SAMPLES, BILLEE L (PHARMD)
Entity Type:Individual
Prefix:
First Name:BILLEE
Middle Name:L
Last Name:SAMPLES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 HALL DR W
Mailing Address - Street 2:
Mailing Address - City:SOUTH JACKSONVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62650-3153
Mailing Address - Country:US
Mailing Address - Phone:309-255-1892
Mailing Address - Fax:
Practice Address - Street 1:701 N 1ST ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62781-0001
Practice Address - Country:US
Practice Address - Phone:217-788-3010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051298579183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist