Individual
ELLEN LISA DALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1701 E KENSINGTON RD, MT PROSPECT, IL 60056-1922
(847) 635-9962
(847) 635-9981
Mailing address
236 S OAK ST, ITASCA, IL 60143-2052
(630) 250-8750
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051035992
IL
Other
Enumeration date
09/08/2011
Last updated
09/08/2011
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