| NPI | 1093971624 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE FERGUSON PIC 630-995-4300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy Compounding Pharmacy (Licence: IL 0540161636) |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| 333600000X Pharmacy | |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2017-03-28 |