| NPI | 1629244223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL C MOLAY Owner 773-763-6655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: IL 016002552) |
| Enumeration Date | 2008-05-02 |
| Last Update Date | 2008-05-02 |