Provider Demographics
NPI:1578745915
Name:MURILLO, JOCELYN DENE
Entity Type:Individual
Prefix:MRS
First Name:JOCELYN
Middle Name:DENE
Last Name:MURILLO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JOCELYN
Other - Middle Name:DENE
Other - Last Name:NOEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:438 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-4012
Mailing Address - Country:US
Mailing Address - Phone:708-358-0935
Mailing Address - Fax:708-358-1173
Practice Address - Street 1:438 MADISON ST
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-4012
Practice Address - Country:US
Practice Address - Phone:708-358-0935
Practice Address - Fax:708-358-1173
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.289865183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist