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Individual

ETHEL WORTHON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
522 TORRENCE AVE, CALUMET CITY, IL 60409-3216
(708) 868-5669
Mailing address
3119 HOLDEN CIR, MATTESON, IL 60443-4430
(708) 932-6560

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051041161
IL

Other

Enumeration date
10/10/2011
Last updated
10/10/2011
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