Individual
ISAAC IBRAHIM BOKTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
221 N WESTERN AVE, WEST PEORIA, IL 61604-5640
(309) 673-0665
Mailing address
221 N WESTERN AVE, WEST PEORIA, IL 61604-5640
(309) 673-0665
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051295553
IL
Other
Enumeration date
01/26/2013
Last updated
01/26/2013
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