- Practice location
- 504 E 47TH St, Chicago, IL 60653-4208
- Phone
- 773-624-0613
- Fax
- 773-624-0204
- Last updated
- June 18, 2008
47TH And Vicennes Professional is a healthcare organization based in Chicago, IL. 47TH And Vicennes Professional practices in Chicago, IL. The NPI Number for 47TH And Vicennes Professional is 1942416938 and holds a License No. 054014942 (IL). The current practice location address for 47TH And Vicennes Professional is 504 E 47TH St, Chicago, IL 60653-4208 and can be reached out via phone at 773-624-0613 and via fax at 773-624-0204.
Provider Profile Details
- NPI Number
- 1942416938
- Provider Name
- 47TH And Vicennes Professional
- Provider Entity Type
- Organization
- Address
- 504 E 47TH St, Chicago, IL 60653-4208
- Phone Number
- 773-624-0613
- Fax Number
- 773-624-0204
- Primary Taxonomy
- Pharmacy, Clinic Pharmacy · 3336C0002X
- Organization Subpart
- No
- Authorized Official
- Zarooq Sabayo · Pharmcist · 773-624-0613
- Provider Enumeration Date
- May 15, 2007
- Last Update Date
- June 18, 2008
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 504 E 47TH St
Chicago, IL 60653-4208 - City
- Chicago
- State
- Illinois
- Zip
- 60653-4208
- Phone Number
- 773-624-0613
- Fax Number
- 773-624-0204
Provider Business Mailing Address Details
- Address
- 504 - 506 E 47TH St
Chicago, IL 60653-4208 - City
- Chicago
- State
- IL
- Zip
- 60653-4208
- Phone Number
- 773-624-0613
- Fax Number
- 773-624-0204
License Information
- License Number
- 054014942
- License State
- IL
- Taxonomy
- Pharmacy, Clinic Pharmacy · 3336C0002X · 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 47TH And Vicennes Professional?
The NPI number of 47TH And Vicennes Professional is 1942416938. It was assigned on May 15, 2007 and is currently active in the NPPES registry.
What is the specialty of 47TH And Vicennes Professional?
47TH And Vicennes Professional is registered under the primary taxonomy Pharmacy, Clinic Pharmacy (code 3336C0002X), licensed in IL under license number 054014942.
Where does 47TH And Vicennes Professional practice?
The practice location is 504 E 47TH St, Chicago, IL 60653-4208. The office can be reached at 773-624-0613 (phone) or 773-624-0204 (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 1942416938 directly on the NPPES registry website.