# GREENLEAF PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043997364
- **Authorized official:** CHIRAG PATEL PHARM D. (PRESIDENT)
- **Authorized official phone:** (847) 346-9958

## Contact information

- **Practice address:** 401 GREENLEAF ST STE 1, PARK CITY, IL 60085-5744
- **Practice address phone:** (847) 242-8267
- **Practice address fax:** (847) 242-8235
- **Mailing address:** 13535 LUCKY LAKE DR, LAKE FOREST, IL 60045-5127
- **Mailing address phone:** (847) 346-9958

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 06/28/2023
- **Last updated:** 06/28/2023