Individual
KELLY BECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1775 W DEMPSTER ST STE TO1116, PARK RIDGE, IL 60068-1143
(847) 692-2184
(847) 692-2467
Mailing address
1775 W DEMPSTER ST STE TO1116, PARK RIDGE, IL 60068-1143
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051291327
IL
Other
Enumeration date
09/29/2011
Last updated
09/29/2011
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