Individual
KELLY OTTENSTROER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1202 STATE ST, LEMONT, IL 60439-4489
(630) 243-1887
Mailing address
1202 STATE ST, LEMONT, IL 60439-4489
(630) 243-1887
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051.293276
IL
Other
Enumeration date
11/18/2013
Last updated
11/18/2013
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