Healthcare Provider Details

I. General information

NPI: 1275626616
Provider Name (Legal Business Name): J AND G PRESCRIPTION PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 W COLLEGE DR
PALOS HEIGHTS IL
60463-1001
US

IV. Provider business mailing address

7600 W COLLEGE DR
PALOS HEIGHTS IL
60463-1001
US

V. Phone/Fax

Practice location:
  • Phone: 708-361-4472
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number StateIL

VIII. Authorized Official

Name: GREG HAKALMAZIAN
Title or Position: PHARMACIST
Credential: RPH
Phone: 708-361-4472