Organization
COOK COUNTY
Active
Parent organization
COOK COUNTY
Other names
FANTUS HEALTH CENTER PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
COOK COUNTY
Authorized official
JOHN BUSKER (ASSISTANT DIRECTOR OF PHARMACY)
(312) 864-2194
Entity
Organization
Contact information
Practice address
1901 W HARRISON ST, CHICAGO, IL 60612-3714
(312) 864-6189
(312) 864-9288
Mailing address
1901 W HARRISON ST, CHICAGO, IL 60612-3714
(312) 864-6189
(312) 864-9288
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
054014914
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2021374
PK
—
Enumeration date
03/27/2007
Last updated
04/25/2016
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