| NPI | 1508149865 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER K KROWN Pharmacist 847-352-0096 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: IL 051.291109) |
| Enumeration Date | 2011-09-23 |
| Last Update Date | 2011-09-23 |