Individual
ALEXANDRIA MARIE HISSONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
5841 S MARYLAND AVE, TW001, MC0010, CHICAGO, IL 60637-1443
(123) 456-7890
Mailing address
5841 S MARYLAND AVE, TW001, MC0010, CHICAGO, IL 60637-1443
Taxonomy
Speciality
Code
Description
License number
State
1835P0200X
Pediatric Pharmacist
Primary
26027068A
IN
Other
Enumeration date
03/22/2019
Last updated
11/16/2020
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