# PAUL DAVIS PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730190232
- **Authorized official:** PAUL DAVIS (OWNER)
- **Authorized official phone:** (773) 489-2383

## Contact information

- **Practice address:** 3624 W WRIGHTWOOD AVE, CHICAGO, IL 60647-1138
- **Practice address phone:** (773) 489-2383
- **Practice address fax:** (773) 489-2384
- **Mailing address:** 3624 W WRIGHTWOOD AVE, CHICAGO, IL 60647-1138

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 54000727 | IL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 08/10/2006
- **Last updated:** 09/11/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1400251 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |