| NPI | 1992843981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM MATTSON Owner 773-929-6555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: IL 054.015154) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2015-01-28 |