Organization
LETITRIDE INC
Active
Other names
Chenoa rx
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC DANIEL URBANOWSKI (AUTHORIZED OFFICIAL)
(815) 945-4211
Entity
Organization
Contact information
Practice address
1000 E CEMETERY AVE, CHENOA, IL 61726-1298
(815) 945-4211
(815) 945-7466
Mailing address
1000 E CEMETERY AVE, CHENOA, IL 61726-1298
(815) 945-4211
(815) 945-7466
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054019487
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2153927
PK
—
Enumeration date
09/20/2006
Last updated
07/17/2026
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