Marc Allen Gaines

NPI #1649550229 in Highland Park, Illinois

Provider Information

NPI Number: 1649550229
Entity Type: Individual
Name: Marc Allen Gaines
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Enumeration Date: Aug 26, 2011
Last Updated: Aug 26, 2011

Practice Location

Address: 1165 COUNTY LINE RD
City: Highland Park
State: Illinois
ZIP Code: 60035-4501
Phone: (847) 433-5514

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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