| NPI | 1083856561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WM MATTSON Owner Rph 773-348-0027 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: IL 054016603) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2016-03-18 |