Healthcare Provider Details

I. General information

NPI: 1053242701
Provider Name (Legal Business Name): SHI-FONG GEORGE PHARM D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 E CHICAGO AVE
CHICAGO IL
60611-2991
US

IV. Provider business mailing address

111 N EMERSON ST
MOUNT PROSPECT IL
60056-2507
US

V. Phone/Fax

Practice location:
  • Phone: 312-227-4150
  • Fax:
Mailing address:
  • Phone: 312-227-4150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051.039813
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: