| NPI | 1053465898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHSIN ALI Acting Pharmacy Manager 847-742-1040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336I0012X Pharmacy Institutional Pharmacy (Licence: IL 059-007700) |
| Additional Taxonomies | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2018-12-19 |