Individual
MR. TIRRELL ANTOINE LIVINGSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7544 S STONY ISLAND AVE, CHICAGO, IL 60649-3926
(773) 667-6959
Mailing address
7848 S SAGINAW AVE, APT. 1A, CHICAGO, IL 60649-5279
(773) 663-8570
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
049.188507
IL
Other
Enumeration date
11/15/2011
Last updated
11/15/2011
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