Healthcare Provider Details

I. General information

NPI: 1750427365
Provider Name (Legal Business Name): CINDYS PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5310 N SHERIDAN RD
CHICAGO IL
60640-2514
US

IV. Provider business mailing address

5310 N SHERIDAN RD
CHICAGO IL
60640-2514
US

V. Phone/Fax

Practice location:
  • Phone: 773-334-4573
  • Fax: 773-334-8225
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number StateIL

VIII. Authorized Official

Name: CYNTHIA FLORES
Title or Position: PRESIDENT AND OWNER
Credential: RPH
Phone: 773-334-4573