Healthcare Provider Details

I. General information

NPI: 1699667147
Provider Name (Legal Business Name): MEDOPTIONS RX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2025
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 E DEVON AVE STE 170
ITASCA IL
60143-1266
US

IV. Provider business mailing address

450 E DEVON AVE STE 170
ITASCA IL
60143-1266
US

V. Phone/Fax

Practice location:
  • Phone: 708-220-5792
  • Fax:
Mailing address:
  • Phone: 833-400-0465
  • Fax: 833-400-0466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER OTTO
Title or Position: CHIEF PHARMACY OFFICER
Credential: RPH
Phone: 708-220-5792