Individual
JAWHARA SOUDAGAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
5580 NORTHWEST HWY, T-1166, CRYSTAL LAKE, IL 60014-8016
(815) 356-9318
(815) 356-9318
Mailing address
5580 NORTHWEST HWY, T-1166, CRYSTAL LAKE, IL 60014-8016
(815) 356-9318
(815) 356-9318
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051.295367
IL
Other
Enumeration date
11/11/2011
Last updated
11/11/2011
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