| NPI | 1477541019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDERICK JAFFE Pharmacist In Charge 815-933-3369 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: IL 054001269) |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2013-03-29 |