| NPI | 1558728519 |
|---|---|
| Doing Business As | PHARMACIST |
| Entity Type | Organization |
| Authorized Contact | JOHN F O'SULLIVAN Pharmacist 630-649-0027 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: IL 051033099) |
| Enumeration Date | 2016-01-21 |
| Last Update Date | 2016-01-21 |