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General NPI Number Information
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NPI Number | 1710342498
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Entity Type | Organization
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Legal Business Name | MAAR ILLINOIS INC
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Dates
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Enumeration Date | 12/22/2015
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Last Update Date | 03/18/2016
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Provider Practice Location Address
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Address Line | 645 S CENTRAL AVE
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City | CHICAGO
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State | IL
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Zip | 60644-5059
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Country | US
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Telephone | 773-854-2500
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Fax | 773-854-2600
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Provider Business Mailing Address
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Address Line | 645 S CENTRAL AVE
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City | CHICAGO
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State | IL
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Zip | 60644-5059
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Country | US
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Telephone | 773-854-2500
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Fax | 773-854-2600
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Authorized Official
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Title or Position | OWNER/PHARMACIST-IN-CHARGE
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Name | RONAK MANEK
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Credential |
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Telephone | 630-747-7495
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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 |
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License Number State |
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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 | 054-019820
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License Number State | IL
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