- Practice location
- 11101 S State St, Chicago, IL 60628-4206
- Phone
- 773-785-5192
- Fax
- 773-821-6970
- Last updated
- August 27, 2013
111TH Pharma - Family is a healthcare organization based in Chicago, IL. 111TH Pharma - Family practices in Chicago, IL. The NPI Number for 111TH Pharma - Family is 1255415386 and holds a License No. 054018137 (IL). The current practice location address for 111TH Pharma - Family is 11101 S State St, Chicago, IL 60628-4206 and can be reached out via phone at 773-785-5192 and via fax at 773-821-6970.
Provider Profile Details
- NPI Number
- 1255415386
- Provider Name
- 111TH Pharma - Family
- Provider Entity Type
- Organization
- Address
- 11101 S State St, Chicago, IL 60628-4206
- Phone Number
- 773-785-5192
- Fax Number
- 773-821-6970
- Primary Taxonomy
- Pharmacy, Community/Retail Pharmacy · 3336C0003X
- Organization Subpart
- No
- Authorized Official
- Adele Vanjackson · Pic · 773-785-5192
- Other Names
- 111TH Pharma Family (Doing Business As)
- Provider Enumeration Date
- October 25, 2006
- Last Update Date
- August 27, 2013
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 11101 S State St
Chicago, IL 60628-4206 - City
- Chicago
- State
- Illinois
- Zip
- 60628-4206
- Phone Number
- 773-785-5192
- Fax Number
- 773-821-6970
Provider Business Mailing Address Details
- Address
- 11101 S State St
Chicago, IL 60628-4206 - City
- Chicago
- State
- IL
- Zip
- 60628-4206
- Phone Number
- 773-785-5192
- Fax Number
- 773-821-6970
License Information
- License Number
- 054018137
- License State
- IL
- Taxonomy
- Pharmacy, Community/Retail Pharmacy · 3336C0003X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of 111TH Pharma - Family?
The NPI number of 111TH Pharma - Family is 1255415386. It was assigned on October 25, 2006 and is currently active in the NPPES registry.
What is the specialty of 111TH Pharma - Family?
111TH Pharma - Family is registered under the primary taxonomy Pharmacy, Community/Retail Pharmacy (code 3336C0003X), licensed in IL under license number 054018137.
Where does 111TH Pharma - Family practice?
The practice location is 11101 S State St, Chicago, IL 60628-4206. The office can be reached at 773-785-5192 (phone) or 773-821-6970 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1255415386 directly on the NPPES registry website.