Healthcare Provider Details

I. General information

NPI: 1053465898
Provider Name (Legal Business Name): ELGIN MENTAL HEALTH CENTER PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 S STATE STREET
ELGIN IL
60123-7692
US

IV. Provider business mailing address

750 S STATE ST
ELGIN IL
60123-7612
US

V. Phone/Fax

Practice location:
  • Phone: 847-742-1040
  • Fax: 847-429-4925
Mailing address:
  • Phone: 847-742-1040
  • Fax: 847-429-4925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number059-007700
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. TEJAS PATEL
Title or Position: PHARMACY MANAGER
Credential: PHARM D
Phone: 847-742-1040