| NPI | 1720356421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGARET GUSTAFSON Cheif Executive Officer 309-852-7520 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy (Licence: IL 054017368) |
| Enumeration Date | 2011-12-08 |
| Last Update Date | 2011-12-08 |