Provider Demographics
NPI:1932118999
Name:JOCHIM, GERALD KENNETH (RPH)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:KENNETH
Last Name:JOCHIM
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:THEODORE
Other - Middle Name:JOSEPH
Other - Last Name:COMMONS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:206 MCKINLEY ST
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:IL
Mailing Address - Zip Code:61846-1935
Mailing Address - Country:US
Mailing Address - Phone:217-662-8242
Mailing Address - Fax:
Practice Address - Street 1:1900 EAST MAIN STREET (119A)
Practice Address - Street 2:VA ILLIANA MEDICAL CENTER
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832
Practice Address - Country:US
Practice Address - Phone:217-554-3000
Practice Address - Fax:217-554-4808
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist