| NPI | 1447532973 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT DIVENEY Pharmacy Supervisor 847-465-0975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IL 051033685) |
| Enumeration Date | 2011-09-10 |
| Last Update Date | 2011-09-10 |