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Individual

MR. JOHN HENRY LEE JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
R. PH.

Contact information

Practice address
7433 S CHAPPEL AVE, CHICAGO, IL 60649-3619
(773) 493-1589
(773) 493-0019
Mailing address
7433 S CHAPPEL AVE, CHICAGO, IL 60649-3619
(773) 493-1589
(773) 493-0019

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051029754
IL
1835P1200X
Pharmacotherapy Pharmacist
051029754
IL
261QC1800X
Corporate Health Clinic/Center
051029754
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
051029754
PHARMACIST LICENSE NUMBER
IL
01
L00046848145
DIVERS LICENSE
IL
Enumeration date
10/20/2011
Last updated
10/20/2011
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