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General NPI Number Information
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NPI Number | 1790841724
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Entity Type | Organization
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Legal Business Name | PROGRESTO INC
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 12/16/2014
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Provider Practice Location Address
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Address Line | 3132 W NORTH AVE FARMACIA SAN JUDAS
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City | CHICAGO
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State | IL
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Zip | 60647-8415
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Country | US
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Telephone | 773-278-2333
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Fax | 708-889-1769
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Provider Business Mailing Address
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Address Line | 3132 W NORTH AVE FARMACIA SAN JUDAS
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City | CHICAGO
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State | IL
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Zip | 60647-8415
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Country | US
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Telephone | 773-278-2333
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Fax | 708-889-1769
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Authorized Official
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Title or Position | PRESIDENT CHIEF PHARMACIST
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Name | MR. CHRISTOPHER D ARCHIBALD
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Credential | RPH
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Telephone | 773-278-2333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 054011952
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License Number State | IL
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