Organization
DUPAGE MEDICAL GROUP LTD.
Active
Other names
JOHA Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA DETELLA PHARMD (PHARMACY MANAGER)
(708) 226-7100
Entity
Organization
Contact information
Practice address
2614 W. JEFFERSON ST., JOLIET, IL 60435
(815) 730-3030
(815) 725-9450
Mailing address
2614 W. JEFFERSON ST., JOLIET, IL 60435
(815) 730-3030
(815) 725-9450
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054014358
IL
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Enumeration date
09/30/2006
Last updated
02/07/2023
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