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General NPI Number Information
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NPI Number | 1023031473
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Entity Type | Organization
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Legal Business Name | J &J PHARMACY LTD.
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 2001 W 69TH STREET CLINIC PHARMACY
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City | CHICAGO
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State | IL
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Zip | 60636
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Country | US
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Telephone | 773-778-2356
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Fax |
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Provider Business Mailing Address
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Address Line | 2001 W 69TH STREET
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City | CHICAGO
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State | IL
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Zip | 60636
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Country | US
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Telephone | 773-778-2356
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Fax |
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Authorized Official
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Title or Position | PRESIDENT PHARMACIST
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Name | MR. JAGDISH P DESAI
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Credential | R PH
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Telephone | 773-778-2356
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 051033681
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 054014217
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License Number State | IL
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