111TH PHARMA-FAMILY
Organization (NPI-2)
Active
Clinic/Center, Health Services
Provider Information
- NPI Number
1659616175- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 11101 S STATE ST, CHICAGO, IL, 606284206
- Phone
- (708) 503-9845
Specialties & Taxonomies
Clinic/Center, Health Services
Primary License: IL #051035317