Healthcare Provider Details

I. General information

NPI: 1033155940
Provider Name (Legal Business Name): DUNDEE PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 06/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2750 DUNDEE RD #9
NORTHBROOK IL
60062-2600
US

IV. Provider business mailing address

2750 DUNDEE RD SUITE 9
NORTHBROOK IL
60062-2600
US

V. Phone/Fax

Practice location:
  • Phone: 847-480-1000
  • Fax: 847-480-1988
Mailing address:
  • Phone: 847-480-1000
  • Fax: 847-480-1988

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 TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number203.001561
License Number StateIL
# 7
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number054015135
License Number StateIL

VIII. Authorized Official

Name: NEIL A MACKLIN
Title or Position: PRESIDENT
Credential: R.PH.
Phone: 847-480-1000