| NPI | 1720097397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELMA J JEAN Owner Pharmacist 708-957-6039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: IL 032005145) |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| 333600000X Pharmacy (Licence: IL 054013140) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2008-04-20 |