# LIFECARE PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LIFECARE PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821460403
- **Authorized official:** ALTAMASH KHAN (MANAGER)
- **Authorized official phone:** (224) 619-9786

## Contact information

- **Practice address:** 276 W FULLERTON AVE, ADDISON, IL 60101-3767
- **Practice address phone:** (630) 543-1000
- **Practice address fax:** (630) 543-1002
- **Mailing address:** 276 W FULLERTON AVE, ADDISON, IL 60101-3767
- **Mailing address phone:** (630) 543-1000
- **Mailing address fax:** (630) 543-1002

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 054.019534 | IL | Yes |

## Other

- **Enumeration date:** 10/22/2015
- **Last updated:** 02/20/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2154865 | PK | — |