Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Organization
FORUM EXTENDED CARE SVC INC II
Active
Organization
FORUM EXTENDED CARE SVC INC II
Active
Other names
FORUM EXTENDED CARE SVC INC II
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN KRAMER (PRESIDENT)
(847) 673-8727
Entity
Organization
Contact information
Practice address
4201 W VICTORIA ST, CHICAGO, IL 60646-6700
(847) 673-8727
(847) 673-6215
Mailing address
4201 W VICTORIA ST, CHICAGO, IL 60646-6700
(847) 673-8727
(847) 673-6215
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
64001297A
IN
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336I0012X
Institutional Pharmacy
1204-43
WI
3336L0003X
Long Term Care Pharmacy
Primary
054017240
IL
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201063520 A
—
IN
01
—
2022130
PK
—
05
—
33245400
—
WI
05
—
36855933001
—
IL
Enumeration date
05/13/2006
Last updated
04/22/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up