Individual
DETELIN DYAKOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5145 N CALIFORNIA AVE, CHICAGO, IL 60625-3661
(773) 989-3810
Mailing address
5145 N CALIFORNIA AVE, CHICAGO, IL 60625-3661
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051293384
IL
Other
Enumeration date
02/18/2014
Last updated
02/18/2014
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