# CERMAK CLINIC PHARMACY

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1114004538
- **Authorized official:** EDWARD FOX (EXEC MANG)
- **Authorized official phone:** (847) 673-2424

## Contact information

- **Practice address:** 6 E CERMAK RD, CHICAGO, IL 60616-2108
- **Practice address phone:** (312) 791-1640
- **Mailing address:** 6 E CERMAK RD, CHICAGO, IL 60616-2108

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 05411305 | IL | Yes |

## Other

- **Enumeration date:** 11/01/2006
- **Last updated:** 04/20/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1465219 | OTHER ID NUMBER | — |