Organization
COMMUNITY FIRST HEALTHCARE OF ILLINOIS
Active
Other names
Addison-Central Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MARY RAPTIS GARCIA (PHARMACY MANAGER)
(773) 282-7434
Entity
Organization
Contact information
Practice address
5600 W ADDISON ST, CHICAGO, IL 60634-4401
(773) 282-7434
(773) 794-4676
Mailing address
5600 W ADDISON ST, CHICAGO, IL 60634-4401
(773) 282-7434
(773) 794-4676
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054018994
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2155817
PK
—
Enumeration date
10/24/2006
Last updated
04/26/2017
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