Provider Demographics
NPI:1740995067
Name:CARBOO, ESTHER AYITSOO (PHARMD)
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:AYITSOO
Last Name:CARBOO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:570 N FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62522-1966
Mailing Address - Country:US
Mailing Address - Phone:217-422-1570
Mailing Address - Fax:
Practice Address - Street 1:570 N FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62522-1966
Practice Address - Country:US
Practice Address - Phone:217-422-1570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-20
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051305339183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist