Provider Demographics
NPI:1659665834
Name:PASKO, KAREN LYNN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:LYNN
Last Name:PASKO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10377 E MILLS RD
Mailing Address - Street 2:
Mailing Address - City:LONDON MILLS
Mailing Address - State:IL
Mailing Address - Zip Code:61544-9374
Mailing Address - Country:US
Mailing Address - Phone:309-486-3578
Mailing Address - Fax:
Practice Address - Street 1:1071 W CARL SANDBURG DR
Practice Address - Street 2:T0891
Practice Address - City:GALESBURG
Practice Address - State:IL
Practice Address - Zip Code:61401-1343
Practice Address - Country:US
Practice Address - Phone:309-344-7886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-05
Last Update Date:2011-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051040277183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist