Individual
MR. GERALD JAMES WASIK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3019 W PETERSON AVE, CHICAGO, IL 60659-3726
(708) 502-7875
Mailing address
3019 W PETERSON AVE, CHICAGO, IL 60659-3726
(708) 502-7875
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051041019
IL
Other
Enumeration date
09/26/2011
Last updated
09/26/2011
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