111TH PHARMA-FAMILY NPI 1659616175

NPI Information

NPI: 1659616175
Provider Name: 111TH PHARMA-FAMILY
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

Address:
11101 S STATE ST
CHICAGO, IL
ZIP 60628
Phone: (708) 503-9845
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111TH PHARMA-FAMILY is a health service clinic center in Chicago, IL. 111TH PHARMA-FAMILY NPI is 1659616175. The provider is registered as an organization entity type.

The provider's business location address is:

11101 S STATE ST
CHICAGO, IL
ZIP 60628-206
Phone: (708) 503-9845

The provider's authorized official is Adele Vanjackson .
The authorized official title is Owner/pharmacist and has the following contact phone number (708) 503-9845.

The enumeration date for this NPI number is 12/10/2012 and was last updated on 12/10/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QH0100X	Clinic/Center	Health Service	051035317	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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