Individual
CHINCHU PERUMBEL JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4748 W NORTH AVE, CHICAGO, IL 60639-4640
(773) 745-6642
Mailing address
4330 N MEADE AVE, CHICAGO, IL 60634-1522
(224) 415-5584
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051.304572
IL
Other
Enumeration date
03/25/2022
Last updated
03/25/2022
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