Healthcare Provider Details

I. General information

NPI: 1528002375
Provider Name (Legal Business Name): GOOD SHEPHERD D O B PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 W HIGHWAY 22
BARRINGTON IL
60010-1901
US

IV. Provider business mailing address

450 W HIGHWAY 22
BARRINGTON IL
60010-1901
US

V. Phone/Fax

Practice location:
  • Phone: 847-381-1230
  • Fax: 847-381-4589
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number54010043
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ALLEN SOUNHEIN
Title or Position: PHARMACIST SUPERVISOR
Credential:
Phone: 847-381-1230