Individual
AMBER LACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10639 S CICERO AVE, OAK LAWN, IL 60453-5269
(708) 424-3594
Mailing address
10639 S CICERO AVE, OAK LAWN, IL 60453-5269
(708) 424-3594
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
049243973
IL
Other
Enumeration date
01/21/2021
Last updated
01/21/2021
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