| NPI | 1801989249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA DETELLA Pharmacy Manager 708-226-7100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: IL 054014358) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0003X Pharmacy Community/Retail Pharmacy | |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2023-02-07 |