| NPI | 1699825786 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE A WITVOET Pharmacy Manager 708-915-5166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IL 054-015155) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2016-02-18 |