Organization
CRYSTAL LAKE PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHIRAG PATEL PHARMD (PRESIDENT)
(847) 346-9958
Entity
Organization
Contact information
Practice address
241 COMMERCE DRIVE, SUITE 102, ROOM A, CRYSTAL LAKE, IL 60014
(779) 800-2340
Mailing address
13535 LUCKY LAKE DR, LAKE FOREST, IL 60045-5127
(847) 346-9958
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
09/27/2023
Last updated
09/27/2023
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