Healthcare Provider Details

I. General information

NPI: 1295761401
Provider Name (Legal Business Name): PROCARE PHARMACEUTICALS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5061 N PULASKI RD
CHICAGO IL
60630-2706
US

IV. Provider business mailing address

5061 N PULASKI RD
CHICAGO IL
60630-2706
US

V. Phone/Fax

Practice location:
  • Phone: 773-463-2157
  • Fax: 773-463-2583
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number StateNULL

VIII. Authorized Official

Name: CHARLES BENAIN
Title or Position: MANAGING PARTNER
Credential:
Phone: 773-463-2157