Healthcare Provider Details

I. General information

NPI: 1023137528
Provider Name (Legal Business Name): JOHN H STROGER JR. HOSPITAL PHARMACY OF COOK COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 04/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 W HARRISON ST RM LL170
CHICAGO IL
60612-3714
US

IV. Provider business mailing address

1901 W HARRISON ST RM LL170
CHICAGO IL
60612-3714
US

V. Phone/Fax

Practice location:
  • Phone: 312-864-2198
  • Fax: 312-864-9288
Mailing address:
  • Phone: 312-864-2198
  • Fax: 312-864-9288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number054.017288
License Number StateIL

VIII. Authorized Official

Name: LORNA PRYOR
Title or Position: PHARMACY MANAGER
Credential: PHARMD
Phone: 312-864-1610