Individual
FANNY MOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 W ADAMS ST, CHICAGO, IL 60606-5208
(312) 372-0331
Mailing address
200 W ADAMS ST, CHICAGO, IL 60606-5208
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051.286764
IL
Other
Enumeration date
08/29/2011
Last updated
08/29/2011
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