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Organization
DUPAGE MEDICAL GROUP LTD.
Active
Organization
DUPAGE MEDICAL GROUP LTD.
Active
Other names
JOHA Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA DETELLA PHARMD (PHARMACY MANAGER)
(708) 226-7100
Entity
Organization
Contact information
Practice address
2614 W. JEFFERSON ST., JOLIET, IL 60435
(815) 730-3030
(815) 725-9450
Mailing address
2614 W. JEFFERSON ST., JOLIET, IL 60435
(815) 730-3030
(815) 725-9450
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
054014358
IL
3336C0003X
Community/Retail Pharmacy
—
NULL
3336C0004X
Compounding Pharmacy
—
NULL
3336S0011X
Specialty Pharmacy
—
NULL
Other
Enumeration date
09/30/2006
Last updated
02/07/2023
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