NPI 1073150066

Joshua Andersen

Practitioner Pharmacist Mt Prospect, IL

Practice location

Address: 1780 Wall St, Mt Prospect, IL 60056-5790
Phone: (847) 264-7100

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 051289323 (IL)

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Registry record

NPI: 1073150066
Entity type: Individual
Sex (as registered): Male
NPI issued: 9 Dec 2019
Record last updated: 9 Dec 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.