Individual
JORDAN ANDERSON AMBROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
820 S DAMEN AVE, CHICAGO, IL 60612-3728
(312) 569-7841
Mailing address
260 E CHESTNUT ST APT 1507, CHICAGO, IL 60611-2411
(630) 988-9838
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051.295278
IL
Other
Enumeration date
08/10/2012
Last updated
08/10/2012
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