Registry details
Type
Individual
Primary specialty
Pharmacist
Enumerated
Nov 30, 2022
License(s)
051.305179 (IL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 239 GOLF MILL CTR | Niles, IL 60714-5658 | |
| LOCATION | 239 GOLF MILL CTR | Niles, IL 60714-5658 | 847-768-9226 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.