# INSTARX PHARMACY LLC

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

## Provider details

- **NPI number:** 1881173656
- **Authorized official:** BRIAN FITZSIMMONS (CEO)
- **Authorized official phone:** (708) 478-0119

## Contact information

- **Practice address:** 18927 HICKORY CREEK DR STE 135, MOKENA, IL 60448
- **Practice address phone:** (708) 478-0119
- **Practice address fax:** (708) 478-0147
- **Mailing address:** 18927 HICKORY CREEK DR STE 135, MOKENA, IL 60448-8649
- **Mailing address phone:** (708) 478-0119
- **Mailing address fax:** (708) 478-0147

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 054.020874 | IL | Yes |

## Other

- **Enumeration date:** 08/12/2018
- **Last updated:** 08/29/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 054.020874 | ILLINOIS BOARD OF PHARMACY LICENSED PHARMACY | IL |
| 01 | — | 320.012772 | ILLINOIS BOARD OF PHARMACY LICENSED CONTROLLED SUBSTANCE LICENSE | IL |