Individual
DR. NICHOLAS SUPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
5000 S 5TH AVE, HINES, IL 60141-3030
(708) 940-1808
Mailing address
831 CLARENCE AVE, OAK PARK, IL 60304-1307
(773) 899-5234
Taxonomy
Speciality
Code
Description
License number
State
1835P2201X
Ambulatory Care Pharmacist
Primary
051.293513
IL
Other
Enumeration date
07/22/2009
Last updated
11/22/2023
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