| NPI | 1184726549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE SCHRADER Executive Director 815-971-3744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336H0001X Pharmacy Home Infusion Therapy Pharmacy (Licence: IL 051.038189) |
| Additional Taxonomies | 3336H0001X Pharmacy Home Infusion Therapy Pharmacy (Licence: IL 054.014567) |
| 3336H0001X Pharmacy Home Infusion Therapy Pharmacy (Licence: IL 320.007402) | |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2012-09-14 |