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Organization
MAAR ILLINOIS INC
Active
Organization
MAAR ILLINOIS INC
Active
Other names
Antillas Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MAHENDRA KHATAU (OWNER)
(773) 722-2626
Entity
Organization
Contact information
Practice address
3109 W ARMITAGE AVE, CHICAGO, IL 60647-3818
(773) 292-5555
Mailing address
3109 W ARMITAGE AVE, CHICAGO, IL 60647-3818
(773) 292-5555
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054018567
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2144870
PK
—
Enumeration date
04/03/2014
Last updated
04/03/2014
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