Provider Demographics
NPI:1649737842
Name:CHAINEY, JILL (RPH)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:CHAINEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:2144 E REPUBLIC RD APT A405
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-4654
Mailing Address - Country:US
Mailing Address - Phone:913-488-9282
Mailing Address - Fax:
Practice Address - Street 1:2144 E REPUBLIC RD APT A405
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-4654
Practice Address - Country:US
Practice Address - Phone:913-488-9282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-23
Last Update Date:2019-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO044739183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist