MEDICARE: MATEL PHARMACY LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0002X	Clinic Pharmacy		IL

General Provider Information

NPI Number	:	1538248075
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MATEL PHARMACY LTD

Provider Business Mailing Address
First Line	:	4714 S CICERO AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60638-2027
Country	:	US
Telephone Number	:	773-767-3600
Fax Number	:

Provider Business Practice Location Address
First Line	:	4714 S CICERO AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60638-2027
Country	:	US
Telephone Number	:	773-767-3600
Fax Number	:

Authorized Official
Title or Position	:	PHARMACIST
Name	:	MR. VINOD M PATEL
Credential	:	RPH
Telephone Number	:	773-767-3600

Provider Enumeration Date	:	11/03/2006
Last Update Date	:	08/22/2020

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Directions to “MATEL PHARMACY LTD ” Practice Location

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