Individual
MRS. ELAINE S TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM D
Contact information
Practice address
891 S. ROUTE 59, BARTLETT, IL 60103
(630) 213-5995
Mailing address
891 S ROUTE 59, BARTLETT, IL 60103
(630) 213-5995
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051-037535
IL
Other
Enumeration date
10/13/2011
Last updated
10/13/2011
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