Healthcare Provider Details

I. General information

NPI: 1609634245
Provider Name (Legal Business Name): CIMPAR PHARMACY OAK PARK, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2024
Last Update Date: 02/02/2026
Certification Date: 02/02/2026
Deactivation Date: 12/22/2025
Reactivation Date: 02/02/2026

III. Provider practice location address

101 MADISON ST SUITE 102
OAK PARK IL
60302-4210
US

IV. Provider business mailing address

101 MADISON ST SUITE 300
OAK PARK IL
60302
US

V. Phone/Fax

Practice location:
  • Phone: 847-423-5593
  • Fax: 708-486-2702
Mailing address:
  • Phone: 773-270-9440
  • Fax: 773-270-9441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DAN ROMAN
Title or Position: CHIEF FINANCIAL & OPERATING OFFICER
Credential:
Phone: 773-415-4030