Individual
DR. DANIEL GLENN DECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM D
Contact information
Practice address
4720 N MARINE DR, CHICAGO, IL 60640
(773) 769-1315
Mailing address
948 MICHIGAN APT 3 B, EVANSTON, IL 60202
(847) 833-6942
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051.291066
IL
Other
Enumeration date
12/09/2011
Last updated
12/09/2011
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