Organization
PROFESSIONAL PHARMACY INC
Active
Other names
PROFESSIONAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
AMIT DHINGRA PHRMD (PIC)
(708) 754-6878
Entity
Organization
Contact information
Practice address
30 E 15TH ST, STE 204, CHICAGO HEIGHTS, IL 60411-3459
(708) 754-6878
(708) 248-6170
Mailing address
30 E 15TH ST, STE 204, CHICAGO HEIGHTS, IL 60411-3459
(708) 754-6878
(708) 248-6170
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
Primary
054016132
IL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1420811
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/28/2007
Last updated
04/16/2012
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