# MIDWEST SPECIALTY PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Midwest Specialty Pharmacy LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578096749
- **Authorized official:** FEDJA TEMIM (DIRECTOR)
- **Authorized official phone:** (312) 690-4585

## Contact information

- **Practice address:** 712 N DEARBORN ST, STE. 3A, CHICAGO, IL 60654-3846
- **Practice address phone:** (312) 690-4585
- **Practice address fax:** (312) 690-4575
- **Mailing address:** 712 N DEARBORN ST, STE. 3A, CHICAGO, IL 60654-3846
- **Mailing address phone:** (312) 690-4585
- **Mailing address fax:** (312) 690-4575

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 054020297 | IL | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 04/05/2017
- **Last updated:** 04/05/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2168676 | PK | — |