Healthcare Provider Details

I. General information

NPI: 1437490836
Provider Name (Legal Business Name): ALPHACARE PHARMACY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2013
Last Update Date: 03/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3207 W FULLERTON AVE
CHICAGO IL
60647-2511
US

IV. Provider business mailing address

3207 W FULLERTON AVE
CHICAGO IL
60647-2511
US

V. Phone/Fax

Practice location:
  • Phone: 773-271-8100
  • Fax: 773-271-8111
Mailing address:
  • Phone: 773-271-8100
  • Fax: 773-271-8111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number054018262
License Number StateIL

VIII. Authorized Official

Name: DR. ANKIT PATEL
Title or Position: OWNER/PHARMACIST
Credential:
Phone: 224-436-9052