# MIDWESTERN REGIONAL MEDICAL CENTER PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MIDWESTERN REGIONAL MEDICAL CENTER PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639298201
- **Authorized official:** GREGG HELM (PHARMACY SUPERVISOR)
- **Authorized official phone:** (847) 872-6390

## Contact information

- **Practice address:** 2520 ELISHA AVE, ZION, IL 60099-2676
- **Practice address phone:** (847) 872-6085
- **Practice address fax:** (847) 872-6063
- **Mailing address:** 2520 ELISHA AVE, PHARMACY, ZION, IL 60099-2676
- **Mailing address phone:** (847) 872-6085
- **Mailing address fax:** (847) 872-6063

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 059003283 | IL | Yes |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 03/28/2007
- **Last updated:** 01/17/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2016972 | PK | — |