Individual
JEFFREY STARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
175 W ARMY TRAIL RD, GLENDALE HEIGHTS, IL 60139-1971
(630) 582-0065
(630) 259-1415
Mailing address
175 W ARMY TRAIL RD, GLENDALE HEIGHTS, IL 60139-1971
(630) 582-0065
(630) 259-1415
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051036613
IL
Other
Enumeration date
10/21/2015
Last updated
10/21/2015
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