| NPI | 1114940467 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD W GATTONE Owner, Rph 815-344-2570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IL 054-005203) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IL 051-023130) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2020-08-22 |