Provider Demographics
NPI:1326563081
Name:SHEFFER, LEAH CHRISTINE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LEAH
Middle Name:CHRISTINE
Last Name:SHEFFER
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 1:619 S SURREY LN
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:IL
Mailing Address - Zip Code:62901-2110
Mailing Address - Country:US
Mailing Address - Phone:312-519-4485
Mailing Address - Fax:
Practice Address - Street 1:619 S SURREY LN
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:IL
Practice Address - Zip Code:62901-2110
Practice Address - Country:US
Practice Address - Phone:312-519-4485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-03
Last Update Date:2017-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051292351183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist