Individual
DALE AIROLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
17033 BURTON AVE, LOCKPORT, IL 60441-4607
(708) 285-3253
Mailing address
17033 BURTON AVE, LOCKPORT, IL 60441-4607
(708) 285-3253
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051029129
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051029129
STATE LICENCE NUMBER
IL
Enumeration date
09/01/2016
Last updated
09/01/2016
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