Healthcare Provider Details
I. General information
NPI: 1356202907
Provider Name (Legal Business Name): RESHAPE RX CHICAGO LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/22/2025
Last Update Date: 11/22/2025
Certification Date: 11/22/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3318 COMMERCIAL AVE
NORTHBROOK IL
60062-1909
US
IV. Provider business mailing address
3318 COMMERCIAL AVE
NORTHBROOK IL
60062-1909
US
V. Phone/Fax
- Phone: 267-253-2537
- Fax:
- Phone: 267-253-2537
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0004X |
| Taxonomy | Compounding Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
CARI
A
LALANDE
Title or Position: PHARMACY DIRECTOR
Credential: PHARMD
Phone: 267-253-2537