Individual
ENRICO BERTUCCI JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
1201 CAMP JACKSON RD, CAHOKIA, IL 62206-2231
(618) 332-2904
(618) 332-2471
Mailing address
1201 CAMP JACKSON RD, CAHOKIA, IL 62206-2231
(618) 332-2904
(618) 332-2471
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051035190
IL
Other
Enumeration date
12/01/2020
Last updated
12/01/2020
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