Healthcare Provider Details

I. General information

NPI: 1265805592
Provider Name (Legal Business Name): PROFESSIONAL PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2015
Last Update Date: 02/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2069 BARRINGTON RD
HOFFMAN ESTATES IL
60169-2086
US

IV. Provider business mailing address

2069 BARRINGTON RD
HOFFMAN ESTATES IL
60169-2086
US

V. Phone/Fax

Practice location:
  • Phone: 224-653-9878
  • Fax: 224-653-9864
Mailing address:
  • Phone: 224-653-9878
  • Fax: 224-653-9864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number054019490
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: AMIT DHINGRA
Title or Position: OWNER, PIC, AO
Credential:
Phone: 630-373-4195