Individual
MR. ANTONIO VALLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
880 ROOSEVELT RD, GLEN ELLYN, IL 60137-6057
(630) 545-9897
Mailing address
880 ROOSEVELT RD., GLEN ELLYN, IL 60137
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051-039140
IL
Other
Enumeration date
11/02/2010
Last updated
11/02/2010
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