| NPI | 1699050641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN MOJA Pharmacist 773-728-6254 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: IL 051292802) |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2011-10-20 |