Individual
BRIAN OVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 SPALDING DR STE 101, NAPERVILLE, IL 60540-6551
(630) 527-5204
Mailing address
196 AMHERST CIR # IR, OSWEGO, IL 60543-5200
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051040331
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
249156
NCPDP
IL
Enumeration date
08/12/2015
Last updated
08/12/2015
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