Individual
MARI LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2939 W ADDISON ST, CHICAGO, IL 60618-4635
(773) 604-7681
Mailing address
2954 W WAVELAND AVE, CHICAGO, IL 60618-4631
(773) 593-5357
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
049.204428
IL
Other
Enumeration date
02/02/2015
Last updated
02/02/2015
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