Organization
COOK COUNTY
Active
Other names
OAK FOREST HOSPITAL E BUILDING PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JUDILYNN BULT (COOK COUNTY HEALTH & HOSPITAL)
(708) 633-4437
Entity
Organization
Contact information
Practice address
15900 S CICERO AVE, OAK FOREST, IL 60452
(708) 633-3708
(708) 633-2295
Mailing address
15900 S CICERO AVE, OAK FOREST, IL 60452
(708) 633-3708
(708) 633-2295
Taxonomy
Speciality
Code
Description
License number
State
3336M0002X
Mail Order Pharmacy
Primary
054.017287
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1483584
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/18/2006
Last updated
12/21/2010
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