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Individual
MR. MARK JOSEPH KLIETHERMES SR.
Active
Individual
MR. MARK JOSEPH KLIETHERMES SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH, MBA
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051-034080
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051-034080
STATE PHARMACY LICENSE
IL
Enumeration date
10/27/2005
Last updated
07/21/2022
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