Organization
WILLOW LAKE PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANKIT J PATEL (PRESIDENT)
(630) 307-6260
Entity
Organization
Contact information
Practice address
303 E ARMY TRAIL RD, SUITE # 108, BLOOMINGDALE, IL 60108-2169
(630) 307-6260
Mailing address
303 E ARMY TRAIL RD, SUITE # 108, BLOOMINGDALE, IL 60108-2169
(630) 307-6260
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
54016230
IL
Other
Enumeration date
07/22/2007
Last updated
07/22/2007
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