Organization
CERMAK CLINIC PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD FOX (EXEC MANG)
(847) 673-2424
Entity
Organization
Contact information
Practice address
6 E CERMAK RD, CHICAGO, IL 60616-2108
(312) 791-1640
Mailing address
6 E CERMAK RD, CHICAGO, IL 60616-2108
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
05411305
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1465219
OTHER ID NUMBER
—
Enumeration date
11/01/2006
Last updated
04/20/2008
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