Organization
CONVEX PHARMACY, LLC
Active
Other names
Convex Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MARYAM ALRAZZAQ PHARM D (PRESIDENT / OWNER)
(708) 460-4930
Entity
Organization
Contact information
Practice address
14400 JOHN HUMPHREY DR, SUITE 110, ORLAND PARK, IL 60462-2897
(708) 460-4930
(708) 460-4932
Mailing address
14400 JOHN HUMPHREY DR, SUITE 110, ORLAND PARK, IL 60462-2897
(708) 460-4930
(708) 460-4932
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
054.018565
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2140286
PK
—
Enumeration date
05/07/2013
Last updated
02/12/2021
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