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Organization
LOCAL HEALTH INC
Active
Organization
LOCAL HEALTH INC
Active
Other names
Logan Square Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SELMA DZELIL PHARMD (VP REGIONAL DIRECTOR)
(815) 715-8502
Entity
Organization
Contact information
Practice address
3600 W FULLERTON AVE STE 27, CHICAGO, IL 60647-2319
(872) 710-9041
Mailing address
3600 W FULLERTON AVE STE 27, CHICAGO, IL 60647-2319
(872) 710-9041
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0002X
Clinic Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
Other
Enumeration date
05/22/2023
Last updated
09/25/2023
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