# MAAR ILLINOIS INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Antillas Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710305008
- **Authorized official:** MAHENDRA KHATAU (OWNER)
- **Authorized official phone:** (773) 722-2626

## Contact information

- **Practice address:** 3109 W ARMITAGE AVE, CHICAGO, IL 60647-3818
- **Practice address phone:** (773) 292-5555
- **Mailing address:** 3109 W ARMITAGE AVE, CHICAGO, IL 60647-3818
- **Mailing address phone:** (773) 292-5555

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 054018567 | IL | Yes |

## Other

- **Enumeration date:** 04/03/2014
- **Last updated:** 04/03/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2144870 | PK | — |