Individual
DR. AMANDA MARIE ELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21000 WESTERN AVE, OLYMPIA FIELDS, IL 60461-1935
(708) 898-9114
Mailing address
9114 CARLISLE LN, ORLAND PARK, IL 60462-3377
(630) 567-1146
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051.299127
IL
Other
Enumeration date
10/27/2020
Last updated
10/27/2020
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