Provider First Line Business Practice Location Address:
9501 S. KING DRIVE, DOUGLAS HALL 203-23
Provider Second Line Business Practice Location Address:
CHICAGO STATE UNIVERSITY COLLEGE OF PHARMACY
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60628
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
773-821-2331
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/14/2013