| NPI | 1659616175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADELE VANJACKSON Owner/Pharmacist 708-503-9845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: IL 051035317) |
| Enumeration Date | 2012-12-10 |
| Last Update Date | 2012-12-10 |