Kelly Decanio
Pharmacy, Community/Retail Pharmacy in Deerfield, IL. Individual provider (NPI-1).
NPI number1669974309
StatusActive
Last updated in NPPESMar 7, 2018
Details
- NPI
- 1669974309
- Entity type
- Individual (NPI-1)
- Name
- Kelly Decanio
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 7, 2018
- Last updated
- Mar 7, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | 051298728 | IL | Yes |
Practice location
1435 Lake Cook RdDeerfield, IL 60015-5213
Phone 847-687-9974
Mailing address
5 Brentwood DrHawthorn Woods, IL 60047-7402
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All 6 Community/Retail Pharmacy providers in Deerfield · All 955 providers in Deerfield
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