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Organization
INTEGRATED CARE PHARMACY
Active
Organization
INTEGRATED CARE PHARMACY
Active
Other names
Integrated Care Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY PANICI (PHARMACIST IN CHARGE)
(224) 360-6100
Entity
Organization
Contact information
Practice address
222 STONE CT, NEW LENOX, IL 60451-1598
(224) 360-6100
Mailing address
222 STONE COURT, NEW LENOX, IL 60451
(224) 360-6100
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
054018100
IL
3336C0004X
Compounding Pharmacy
Primary
054018100
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2138272
PK
—
Enumeration date
01/31/2013
Last updated
04/07/2015
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