Individual
KATHLEEN WIERSEMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6401 W 127TH ST, PALOS HEIGHTS, IL 60463-2247
(708) 371-0343
Mailing address
6401 W 127TH ST, PALOS HEIGHTS, IL 60463-2247
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051288521
IL
Other
Enumeration date
11/01/2010
Last updated
11/01/2010
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