| NPI | 1073982161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN NIELSEN Treasurer 847-315-3523 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2016-09-27 |