| NPI | 1780132068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA NODAL Administrator 312-915-0938 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2016-09-15 |
| Last Update Date | 2016-09-15 |