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Individual

ELLEN J LARSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RPH

Contact information

Practice address
5TH AND ROOSEVELT ROADS, HINES, IL 60141
(708) 786-7820
Mailing address
6923 W SHAKESPEARE AVE, CHICAGO, IL 60707-3355
(773) 889-3119
(773) 385-6673

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051032182
IL

Other

Enumeration date
07/16/2008
Last updated
07/16/2008
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