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General NPI Number Information
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NPI Number | 1801823091
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Entity Type | Organization
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Legal Business Name | BECKER PROFESSIONAL PHARMACY INC
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 09/14/2016
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Provider Practice Location Address
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Address Line | 4744 N WESTERN AVE
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City | CHICAGO
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State | IL
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Zip | 60625-2013
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Country | US
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Telephone | 773-334-1060
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Fax | 773-334-3162
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Provider Business Mailing Address
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Address Line | 4744 N WESTERN AVE
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City | CHICAGO
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State | IL
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Zip | 60625-2013
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Country | US
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Telephone | 773-334-1060
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Fax | 773-334-3162
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALVIN KLEIN
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Credential |
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Telephone | 273-561-4486
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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 | 054.004739
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License Number State | IL
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