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General NPI Number Information
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NPI Number | 1205837820
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Entity Type | Organization
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Legal Business Name | BECKER PROFESSIONAL PHARMACY INC
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Dates
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Enumeration Date | 08/04/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4744 N WESTERN AVE
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City | CHICAGO
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State | IL
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Zip | 60625-2013
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Country | US
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Telephone | 773-561-4486
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Fax | 773-334-3162
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Provider Business Mailing Address
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Address Line | 4744 N WESTERN AVE
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City | CHICAGO
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State | IL
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Zip | 60625-2013
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Country | US
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Telephone | 773-561-4486
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Fax | 773-334-3162
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Authorized Official
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Title or Position | PRESIDENT/PHARMACIST IN CHARGE
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Name | MR. ALVIN CHARLES KLEIN
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Credential | RPH
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Telephone | 773-561-4486
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 54004739
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License Number State | IL
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