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Individual

ALTIJANA GALLUP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
61 S ROUTE 12, FOX LAKE, IL 60020-1750
(847) 587-8222
(847) 587-0096
Mailing address
61 S ROUTE 12, FOX LAKE, IL 60020-1750
(847) 587-8222
(847) 587-0096

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051.291168
IL

Other

Enumeration date
09/26/2011
Last updated
09/26/2011
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