Organization
VICTORY RX, INC
Active
Other names
Local Health Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SELMA DZELIL PHARMD. (VP RDO)
(815) 715-8502
Entity
Organization
Contact information
Practice address
2545 W. DIVERSEY AVE STE. 104, CHICAGO, IL 60647
(773) 673-5493
(844) 224-0287
Mailing address
2545 W. DIVERSEY AVE STE. 104, CHICAGO, IL 60647
(773) 673-5493
(844) 224-0287
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054.020635
IL
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2159908
PK
—
Enumeration date
05/04/2016
Last updated
09/25/2023
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