Individual
EDWARD J PRAISA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
101 N STATE ST, MARENGO, IL 60152-2217
(815) 568-7242
(815) 568-7242
Mailing address
101 N STATE ST, MARENGO, IL 60152-2217
(815) 568-7242
(815) 568-0428
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
054004373
IL
Other
Enumeration date
06/08/2017
Last updated
06/08/2017
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