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1013983105
KENNETH MARK BODENHAGEN
BOLINGBROOK, IL
NPI
1013983105
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: IL 051-286078)
Enumeration Date
2006-02-27
Last Update Date
2007-07-08
Business Address
Dr. KENNETH MARK BODENHAGEN Pharm D
225 N WEBER RD
BOLINGBROOK, IL 60490-1505
Phone number: 630-679-6533
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Mailing Address
Dr. KENNETH MARK BODENHAGEN Pharm D
13963 S TRAILS END DR
HOMER GLEN, IL 60491-8643
Phone number: 708-645-1678
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