Organization
MAAR ILLINOIS INC
Active
Other names
Austin Outpatient Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RONAK MANEK (OWNER/PHARMACIST-IN-CHARGE)
(630) 747-7495
Entity
Organization
Contact information
Practice address
645 S CENTRAL AVE, CHICAGO, IL 60644-5059
(773) 854-2500
(773) 854-2600
Mailing address
645 S CENTRAL AVE, CHICAGO, IL 60644-5059
(773) 854-2500
(773) 854-2600
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
054-019820
IL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2155826
PK
—
Enumeration date
12/22/2015
Last updated
03/18/2016
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