| NPI | 1801261359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA C TANGONAN Pharmacy Clinical Services Manager 708-890-0106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: IL 051297740) |
| Enumeration Date | 2015-12-09 |
| Last Update Date | 2015-12-09 |