Individual
DOUGLAS NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7851 CATON FARM RD, PLAINFIELD, IL 60586-1601
(815) 436-2123
Mailing address
14123 MEADOW LN, PLAINFIELD, IL 60544-1542
(773) 620-3863
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051040829
IL
Other
Enumeration date
10/17/2011
Last updated
10/17/2011
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