# WILLOW LAKE PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346440963
- **Authorized official:** ANKIT J PATEL (PRESIDENT)
- **Authorized official phone:** (630) 307-6260

## Contact information

- **Practice address:** 303 E ARMY TRAIL RD, SUITE \# 108, BLOOMINGDALE, IL 60108-2169
- **Practice address phone:** (630) 307-6260
- **Mailing address:** 303 E ARMY TRAIL RD, SUITE \# 108, BLOOMINGDALE, IL 60108-2169
- **Mailing address phone:** (630) 307-6260

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 54016230 | IL | Yes |

## Other

- **Enumeration date:** 07/22/2007
- **Last updated:** 07/22/2007