| NPI | 1902934268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD KIELAR Pharmacist In Charge 773-274-7885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy (Licence: IL IL05411448) |
| Additional Taxonomies | 3336M0003X Pharmacy, Managed Care Organization Pharmacy |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2011-02-22 |