Individual
ELLEN BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
222 S RIVERSIDE PLZ, 830, CHICAGO, IL 60606-5808
(312) 416-3804
Mailing address
222 S RIVERSIDE PLZ, 830, CHICAGO, IL 60606-5808
(312) 416-3804
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051287424
IL
Other
Enumeration date
06/30/2016
Last updated
06/30/2016
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