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Individual

MR. JEROME J SHALLON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
626 RIVER OAKS DR, CALUMET CITY, IL 60409-5712
(708) 891-0039
(708) 891-2426
Mailing address
12095 S OAKWOOD DR, SAINT JOHN, IN 46373-9763
(219) 365-7232
(708) 891-2426

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051-031785
IL

Other

Enumeration date
09/08/2011
Last updated
09/08/2011
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