Healthcare Provider Details

I. General information

NPI: 1902801087
Provider Name (Legal Business Name): CONSUMERS PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SURREYBROOK PLAZA
SAUK VILLAGE IL
60411
US

IV. Provider business mailing address

1 SURREYBROOK PLAZA
SAUK VILLAGE IL
60411
US

V. Phone/Fax

Practice location:
  • Phone: 708-757-4030
  • Fax: 708-757-4728
Mailing address:
  • Phone: 708-757-4030
  • Fax: 708-757-4728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number0053008445
License Number StateIL

VIII. Authorized Official

Name: MR. JOHN J HEBDA
Title or Position: PRESIDENT
Credential: RPH
Phone: 708-757-4030