Organization
WELLCARE PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HANI ABDALLAH RPH (OWNER, AO, PHCY MANAGER, PIC)
(708) 307-7839
Entity
Organization
Contact information
Practice address
9760 S KEDZIE AVE, EVERGREEN PARK, IL 60805-3109
(708) 930-5927
(708) 930-5935
Mailing address
9760 S KEDZIE AVE, EVERGREEN PARK, IL 60805-3109
(708) 930-5927
(708) 930-5935
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054020144
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2167135
PK
—
Enumeration date
12/22/2016
Last updated
03/23/2017
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up