Provider Demographics
NPI:1629359658
Name:KUEKER, JANET RENEE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:RENEE
Last Name:KUEKER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:JANET
Other - Middle Name:RENEE
Other - Last Name:DICKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:43 THICKET LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH BELOIT
Mailing Address - State:IL
Mailing Address - Zip Code:61080-2491
Mailing Address - Country:US
Mailing Address - Phone:815-218-1573
Mailing Address - Fax:
Practice Address - Street 1:43 THICKET LN
Practice Address - Street 2:
Practice Address - City:SOUTH BELOIT
Practice Address - State:IL
Practice Address - Zip Code:61080-2491
Practice Address - Country:US
Practice Address - Phone:815-218-1573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-05
Last Update Date:2011-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051292632183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist