Individual
ALEX J WALLACE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
R.PH,
Contact information
Practice address
530 SPRUCE LANE, LISLE, IL 60532-4370
(630) 663-1620
Mailing address
530 SPRUCE LANE, LISLE, IL 60532-4370
(630) 663-1620
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
—
IL
Other
Enumeration date
08/01/2005
Last updated
07/08/2007
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