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General NPI Number Information
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NPI Number | 1497635882
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Entity Type | Individual
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Provider Name | MARK JUSTIN ALVENDIA LIM RPH
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Gender | Male
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Dates
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Enumeration Date | 09/05/2025
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 7050 S CICERO AVE
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City | BEDFORD PARK
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State | IL
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Zip | 60638-6402
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Country | US
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Telephone | 708-496-0230
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Fax |
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Provider Business Mailing Address
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Address Line | 3108 N ODELL AVE
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City | CHICAGO
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State | IL
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Zip | 60707-1239
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Country | US
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Telephone | 773-559-0707
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 051.306852
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License Number State | IL
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