111TH PHARMA - FAMILY
Organization (NPI-2)
Active
Pharmacy, Community/Retail Pharmacy
Provider Information
- NPI Number
1255415386- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 11101 S STATE ST, CHICAGO, IL, 606284206
- Phone
- (773) 785-5192
- Fax
- (773) 821-6970
Specialties & Taxonomies
Pharmacy, Community/Retail Pharmacy
Primary License: IL #054018137