MR. Lysle R Pietsch

NPI #1013290733 in Hanover Park, Illinois

Provider Information

NPI Number: 1013290733
Entity Type: Individual
Name: MR. Lysle R Pietsch
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Enumeration Date: Sep 20, 2011
Last Updated: Sep 20, 2011

Practice Location

Address: 2040 ARMY TRAIL RD
City: Hanover Park
State: Illinois
ZIP Code: 60133-8975
Phone: (630) 830-6451

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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