# TINLEY PARK PHARMACY, INC

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

## Provider details

- **NPI number:** 1780066456
- **Authorized official:** DR. MARY HADDADIN PHARMD (OWNER)
- **Authorized official phone:** (312) 804-9469

## Contact information

- **Practice address:** 18210 S. LAGRANGE RD, SUITE 101, TINLEY PARK, IL 60487-7722
- **Practice address phone:** (708) 995-7290
- **Practice address fax:** (708) 995-7371
- **Mailing address:** 18210 S. LAGRANGE RD, SUITE 101, TINLEY PARK, IL 60487-7722
- **Mailing address phone:** (708) 995-7290
- **Mailing address fax:** (708) 995-7371

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 054.019388 | IL | — |
| 3336C0003X | Community/Retail Pharmacy | 054.019388 | IL | Yes |

## Other

- **Enumeration date:** 06/18/2015
- **Last updated:** 06/18/2015