Individual
DONNA WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
137 W NORTH AVE, NORTHLAKE, IL 60164-2316
(708) 409-0046
(708) 409-0268
Mailing address
340 HIGH RIDGE RD, HILLSIDE, IL 60162-1621
(708) 655-7001
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051036334
IL
Other
Enumeration date
10/28/2020
Last updated
10/28/2020
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