# CORDANT PHARMACY ILLINOIS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CORDANT PHARMACY ILLINOIS, LLC
- **Other names:** Cordant Pharmacy Solutions \#R118
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1952909632
- **Legal business name:** CORDANT PHARMACY ILLINOIS, LLC
- **Authorized official:** FARA TIPPIT (EXECUTIVE ASSISTANT)
- **Authorized official phone:** (720) 272-3535

## Contact information

- **Practice address:** 8623 W BRYN MAWR AVE STE 504, CHICAGO, IL 60631-3525
- **Practice address phone:** (872) 264-5673
- **Mailing address:** 1620 W NORTHWEST HWY STE 100, GRAPEVINE, TX 76051-3219

## Taxonomy

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

## Other

- **Enumeration date:** 10/14/2020
- **Last updated:** 10/14/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 054.021576 | ILLINOIS BOARD OF PHARMACY | IL |