Provider Demographics
NPI:1417281825
Name:FORTIER, JANET CAROL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:CAROL
Last Name:FORTIER
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 1:316 SHADOW HILL DR
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60124-3815
Mailing Address - Country:US
Mailing Address - Phone:847-610-0186
Mailing Address - Fax:
Practice Address - Street 1:316 SHADOW HILL DR
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60124-3815
Practice Address - Country:US
Practice Address - Phone:847-610-0186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.288391183500000X
IN26022735A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist