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General NPI Number Information
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NPI Number | 1437509890
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Entity Type | Organization
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Legal Business Name | OSCO DRUG
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Dates
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Enumeration Date | 06/16/2016
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Last Update Date | 06/16/2016
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Provider Practice Location Address
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Address Line | 3400 N WESTERN AVE
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City | CHICAGO
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State | IL
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Zip | 60618-6012
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Country | US
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Telephone | 773-327-4094
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Fax |
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Provider Business Mailing Address
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Address Line | 781 CAITLIN CT
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City | GRAYSLAKE
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State | IL
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Zip | 60030-3204
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | DR. SARAH STOLZ
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Credential |
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Telephone | 847-567-1483
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 051.298158
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License Number State | IL
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