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General NPI Number Information
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NPI Number | 1871633578
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Entity Type | Organization
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Legal Business Name | NORTHTOWN DRUGS
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2158 W DEVON AVE
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City | CHICAGO
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State | IL
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Zip | 60659-2127
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Country | US
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Telephone | 773-743-0887
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Fax | 773-743-0797
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Provider Business Mailing Address
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Address Line | 2158 W DEVON AVE
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City | CHICAGO
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State | IL
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Zip | 60659-2127
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Country | US
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Telephone | 773-743-0887
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Fax | 773-743-0797
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. MICHAEL NELSON
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Credential | R.PH
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Telephone | 773-743-0887
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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 | IL
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