Pamela Lyn Letzkus, PHARM.D
Individual provider Active NPI Pharmacist · Clinton, IL
NPI 1164574034 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1164574034
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- Practice address
- 422 W White St
Clinton, IL 61727-2272 - Phone
- (217) 935-9571
- Fax
- (217) 937-5250
- NPI assigned
- Jan 18, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051288914 | IL | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | IL | Yes |
Addresses
Primary practice location
422 W White St
Clinton, IL 61727-2272
Mailing address
705 Thomas Dr
Heyworth, IL 61745-9325
Phone (217) 935-9571
Other providers in Clinton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.