Provider Demographics
NPI:1740576859
Name:AMOS YOCH, ILONKA MARIA (RPH)
Entity Type:Individual
Prefix:MS
First Name:ILONKA
Middle Name:MARIA
Last Name:AMOS YOCH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3400 GREEN MOUNT CROSSING DR
Mailing Address - Street 2:T1539
Mailing Address - City:SHILOH
Mailing Address - State:IL
Mailing Address - Zip Code:62269-7277
Mailing Address - Country:US
Mailing Address - Phone:618-628-3334
Mailing Address - Fax:618-628-3334
Practice Address - Street 1:3400 GREEN MOUNT CROSSING DR
Practice Address - Street 2:T1539
Practice Address - City:SHILOH
Practice Address - State:IL
Practice Address - Zip Code:62269-7277
Practice Address - Country:US
Practice Address - Phone:618-628-3334
Practice Address - Fax:618-628-3334
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.037736183500000X
MO042194183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist