Organization
WALGREENS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DORTHY J EVANS PHARM D (PHARMACIST)
(618) 394-8744
Entity
Organization
Contact information
Practice address
6505 N ILLINOIS ST, FAIRVIEW HEIGHTS, IL 62208-2001
(618) 394-8744
(618) 394-1026
Mailing address
6505 N ILLINOIS ST, FAIRVIEW HEIGHTS, IL 62208-2001
(618) 394-8744
(618) 394-1026
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
051-036497
IL
Other
Enumeration date
08/25/2011
Last updated
08/25/2011
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