Organization
DU PAGE MEDICAL GROUP LTD
Active
Other names
LaGrange Road Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
NITIKA AGARWAL (DIRECTOR OF PHARMACY)
(630) 432-6371
Entity
Organization
Contact information
Practice address
17495 LA GRANGE RD, TINLEY PARK, IL 60487-7581
(708) 226-7100
(708) 226-7178
Mailing address
17495 LA GRANGE RD, TINLEY PARK, IL 60487-7581
(708) 226-7100
(708) 226-7178
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
054019950
IL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2162402
PK
—
Enumeration date
12/08/2006
Last updated
03/20/2017
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