| NPI | 1043252570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNE RUDD Owner/Sec/ Phcist 815-301-2055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: IL 5401552) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2020-08-22 |