# LAWRENCE HOUSE

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** STATE OF ILLINOIS
- **Other names:** Pharmacist
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1558728519
- **Legal business name:** STATE OF ILLINOIS
- **Authorized official:** MR. JOHN F O'SULLIVAN RPH (PHARMACIST)
- **Authorized official phone:** (630) 649-0027

## Contact information

- **Practice address:** 1001 W LAWRENCE AVE, CHICAGO, IL 60640-5017
- **Practice address phone:** (773) 561-2288
- **Mailing address:** 5953 OAKWOOD DR, LISLE, IL 60532-3011
- **Mailing address phone:** (630) 649-0027

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | 051033099 | IL | Yes |

## Other

- **Enumeration date:** 01/21/2016
- **Last updated:** 01/21/2016