Individual
NOURA KESHTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
944 S YORK ST, ELMHURST, IL 60126-5157
(630) 834-2000
Mailing address
4021 ARTHUR AVE, BROOKFIELD, IL 60513-1949
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
051.304014
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051304014
RPH LICENSE
IL
Enumeration date
08/28/2021
Last updated
08/28/2021
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