Provider Demographics
NPI:1790794428
Name:SHUMAKER, LINDA BLACK (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:BLACK
Last Name:SHUMAKER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16881 E 2705 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61834-6060
Mailing Address - Country:US
Mailing Address - Phone:217-759-7829
Mailing Address - Fax:217-759-7829
Practice Address - Street 1:1900 E MAIN ST
Practice Address - Street 2:119
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832-5100
Practice Address - Country:US
Practice Address - Phone:217-554-4239
Practice Address - Fax:217-554-4808
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist