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Individual

DR. CAROLYN J WIKSTROM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHARM.D.

Contact information

Practice address
15850 S 94TH AVE, T-0842, ORLAND PARK, IL 60462-4725
(708) 349-1383
(708) 349-1383
Mailing address
15850 S 94TH AVE, T-0842, ORLAND PARK, IL 60462-4725
(708) 349-1383
(708) 349-1383

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051037074
IL

Other

Enumeration date
06/10/2011
Last updated
06/10/2011
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