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Organization
ADVOCATE HEALTH AND HOPSITALS CORPORATION
Active
Organization
ADVOCATE HEALTH AND HOPSITALS CORPORATION
Active
Other names
CHRIST HOSPITAL OUTPATIENT PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ANNE HICKMAN PHARM D (PHARMACY SUPERVISOR)
(708) 684-5275
Entity
Organization
Contact information
Practice address
4400 W 95TH ST STE 101, DEPARTMENT OF PHARMACY, OAK LAWN, IL 60453-2655
(708) 684-5275
(708) 684-1712
Mailing address
4400 W 95TH ST STE 101, DEPARTMENT OF PHARMACY, OAK LAWN, IL 60453-2655
(708) 684-5275
(708) 684-1712
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054008972
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1431698
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/30/2007
Last updated
12/05/2012
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