{
"Npi": {
"NPI": "1588422125",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CIMPAR PHARMACY LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "101 MADISON ST",
"SecondLineMailingAddress": "SUITE 300",
"MailingAddressCityName": "OAK PARK",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60302",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "847-423-5593",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "501 W NORTH AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MELROSE PARK",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60160-1603",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "847-423-5593",
"PracticeLocationAddressFaxNumber": "708-486-2702",
"EnumerationDate": "03/08/2024",
"LastUpdateDate": "01/28/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": "12/22/2025",
"NPIReactivationDate": "01/28/2026",
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ROMAN",
"AuthorizedOfficialFirstName": "DAN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CHIEF FINANCIAL & OPERATING OFFICER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "773-415-4030",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "3336L0003X",
"TaxonomyName": "Long Term Care Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336H0001X",
"TaxonomyName": "Home Infusion Therapy Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}