Organization
29 E MADISON CORP
Active
Other names
IVAN T MATTHEI PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MARK EDELHEIT RPH (OWNER)
(312) 263-7194
Entity
Organization
Contact information
Practice address
25 E WASHINGTON ST LOWR 53, LOWER LEVEL PEDWAY, CHICAGO, IL 60602-1736
(312) 263-7194
(312) 263-7636
Mailing address
25 E WASHINGTON ST LOWR 53, LOWER LEVEL PEDWAY, CHICAGO, IL 60602-1736
(312) 263-7194
(312) 263-7636
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054013583
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1449948
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
6060201
—
IL
Enumeration date
10/20/2006
Last updated
03/09/2010
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up