Individual
ELAINE VILLANUEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
424 W DIVISION ST, CHICAGO, IL 60610-1727
(312) 274-1706
Mailing address
2021 W CHICAGO AVE, CHICAGO, IL 60622-5549
(773) 799-9004
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051295785
IL
Other
Enumeration date
07/25/2012
Last updated
02/02/2015
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