Individual
SHKIRAH MOTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD.
Contact information
Practice address
225 JOLIET ST, DYER, IN 46311-1709
(219) 322-3014
Mailing address
5152 PEARSON ST, MATTESON, IL 60443-3112
(708) 238-9423
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26029103A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1952798993
PHARMACY
IN
Enumeration date
12/22/2020
Last updated
12/22/2020
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