Individual
MR. CHARLES NOLIS ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM. D
Contact information
Practice address
17605 S. HALSTED STREET, HOMEWOOD, IL 60430
(708) 335-5250
Mailing address
457 E 41ST ST, CHICAGO, IL 60653-2705
(773) 808-4310
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051296289
IL
Other
Enumeration date
10/18/2012
Last updated
10/18/2012
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