Individual
KELLY MATCHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21164 S LA GRANGE RD, FRANKFORT, IL 60423-2010
(815) 464-5050
Mailing address
21164 S LA GRANGE RD, FRANKFORT, IL 60423-2010
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051288001
IL
Other
Enumeration date
05/23/2016
Last updated
05/23/2016
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