Individual
JEFFREY MA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
4830 GRAND AVE, GURNEE, IL 60031-2618
(847) 662-2585
Mailing address
4830 GRAND AVE, GURNEE, IL 60031-2618
(847) 662-2585
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051287363
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
362127039056
—
IL
Enumeration date
09/11/2011
Last updated
09/11/2011
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