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Organization

JOLIET PROFESSIONAL PHARMACY CORP.

Active
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Organization

JOLIET PROFESSIONAL PHARMACY CORP.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHAD KODIAK (PRESIDENT)
(815) 725-9314
Entity
Organization

Contact information

Practice address
2401 W JEFFERSON ST STE 200, JOLIET, IL 60435-6428
(815) 725-9315
(815) 725-3372
Mailing address
2401 W JEFFERSON ST STE 200, JOLIET, IL 60435-7830
(815) 725-9314
(815) 725-7032

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
054-004174
IL
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
054-004174
IL
3336L0003X
Long Term Care Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—

Other

Enumeration date
02/13/2007
Last updated
07/08/2026
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