Individual
GRACE GO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2150 PFINGSTEN RD STE B206, GLENVIEW, IL 60026-1361
(847) 657-6894
Mailing address
8319 N OKETO AVE, NILES, IL 60714-2515
(916) 477-9680
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051.301446
IL
Other
Enumeration date
09/24/2018
Last updated
09/24/2018
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