Organization
LITTLE VILLAGE PHARMACY INC
Active
Other names
PROPACK PHARMACY, LITTLE VILLAGE PHARMACY, INC
Organization subpart
No
Provider details
NPI number
Authorized official
MITESH D PATEL (PHARMACY MANAGER)
(708) 303-5151
Entity
Organization
Contact information
Practice address
3811 W 26TH ST, CHICAGO, IL 60623-3808
(773) 522-2121
(773) 522-4040
Mailing address
3811 W 26TH ST, CHICAGO, IL 60623-3808
(773) 522-2121
(773) 522-4040
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054016636
IL
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2119668
PK
—
Enumeration date
04/03/2009
Last updated
03/20/2023
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