| NPI | 1174734974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE F DE RUITER COO 708-308-0553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy Clinic Pharmacy (Licence: IL 54016193) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-08-22 |