Individual
CLARISSA FASBENDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2656 N ELSTON AVE, CHICAGO, IL 60647-2019
(773) 252-2210
Mailing address
2656 N ELSTON AVE, CHICAGO, IL 60647-2019
(773) 252-2210
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051303258
IL
Other
Enumeration date
11/24/2020
Last updated
11/24/2020
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