Individual
MRS. ANDREA JEAN SOUTHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH,CDM
Contact information
Practice address
354 N LAGRANGE RD, FRANKFORT, IL 60423-2008
(708) 389-2725
Mailing address
12003 S CRAWFORD, ALSIP, IL 60803
(708) 389-2725
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
—
IL
Other
Enumeration date
12/04/2007
Last updated
12/04/2007
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