Individual
KELLY ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM.D,CCP
Contact information
Practice address
5525 S PULASKI RD, CHICAGO, IL 60629-4400
(773) 432-0100
(773) 432-0101
Mailing address
5525 S PULASKI RD, CHICAGO, IL 60629-4400
(773) 432-0100
(773) 432-0101
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
051295532
IL
183500000X
Pharmacist
054233
NY
183500000X
Pharmacist
Primary
28RI03147600
NJ
Other
Enumeration date
12/08/2010
Last updated
06/28/2013
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