Individual
GEORGIANA ISMAIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5000 S 5TH AVE, HINES, IL 60141-3030
(708) 202-2108
Mailing address
5000 S 5TH AVE, HINES, IL 60141-3030
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051300848
IL
Other
Enumeration date
10/13/2017
Last updated
10/13/2017
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