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Organization
DU PAGE MEDICAL GROUP LTD
Active
Organization
DU PAGE MEDICAL GROUP LTD
Active
Other names
LaGrange Road Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
NITIKA AGARWAL (DIRECTOR OF PHARMACY)
(630) 432-6371
Entity
Organization
Contact information
Practice address
17495 LA GRANGE RD, TINLEY PARK, IL 60487-7581
(708) 226-7100
(708) 226-7178
Mailing address
17495 LA GRANGE RD, TINLEY PARK, IL 60487-7581
(708) 226-7100
(708) 226-7178
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
054019950
IL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2162402
PK
—
Enumeration date
12/08/2006
Last updated
03/20/2017
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