Individual
JENNIFER COLCLASURE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
9650 W 131ST ST, PALOS PARK, IL 60464-1640
(708) 361-8090
Mailing address
9650 W 131ST ST, PALOS PARK, IL 60464-1640
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051292469
IL
Other
Enumeration date
05/12/2016
Last updated
05/12/2016
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