Organization
ADVOCATE HEALTH AND HOPSITALS CORPORATION
Active
Other names
CHRIST HOSPITAL OUTPATIENT PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ANNE HICKMAN PHARM D (PHARMACY SUPERVISOR)
(708) 684-5275
Entity
Organization
Contact information
Practice address
4400 W 95TH ST STE 101, DEPARTMENT OF PHARMACY, OAK LAWN, IL 60453-2655
(708) 684-5275
(708) 684-1712
Mailing address
4400 W 95TH ST STE 101, DEPARTMENT OF PHARMACY, OAK LAWN, IL 60453-2655
(708) 684-5275
(708) 684-1712
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054008972
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1431698
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/30/2007
Last updated
12/05/2012
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