Organization
ILLINOIS COMPOUNDING PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TUSHAR MEHTA RPH (PHARMACY MANAGER)
(630) 430-3663
Entity
Organization
Contact information
Practice address
1117 S MILWAUKEE AVE STE A2, LIBERTYVILLE, IL 60048-3754
(847) 242-8281
(847) 232-7425
Mailing address
310 OTTAWA LN, OAK BROOK, IL 60523-2788
(630) 430-3663
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
—
—
Other
Enumeration date
03/20/2025
Last updated
03/20/2025
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