# KORLE BU PHARMACY LLC

> 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
- **Other names:** KORLE BU PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114065976
- **Authorized official:** PRASHANT PATEL PHARM D (PHARMICIST IN CHARGE)
- **Authorized official phone:** (847) 858-4776

## Contact information

- **Practice address:** 5517 S MICHIGAN AVE, CHICAGO, IL 60637-1012
- **Practice address phone:** (773) 321-2656
- **Practice address fax:** (773) 667-9815
- **Mailing address:** 5 OSPREY CT, STREAMWOOD, IL 60107-2813

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0002X | Clinic Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 54016112 | IL | Yes |

## Other

- **Enumeration date:** 02/02/2007
- **Last updated:** 03/24/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1480350 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |