Provider Demographics
NPI:1992844773
Name:SCHILLING, JACKIE LYNNE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JACKIE
Middle Name:LYNNE
Last Name:SCHILLING
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 1:749 SOUTHWIND DR
Mailing Address - Street 2:
Mailing Address - City:LAKE VILLA
Mailing Address - State:IL
Mailing Address - Zip Code:60046-6685
Mailing Address - Country:US
Mailing Address - Phone:847-245-7156
Mailing Address - Fax:
Practice Address - Street 1:1707 7TH ST
Practice Address - Street 2:SUITE 4
Practice Address - City:WINTHROP HARBOR
Practice Address - State:IL
Practice Address - Zip Code:60096-1656
Practice Address - Country:US
Practice Address - Phone:847-872-5427
Practice Address - Fax:847-872-9645
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist