MEDICARE: LUNA PHARMACY AT SOUTH SHORE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1053888990
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUNA PHARMACY AT SOUTH SHORE LLC

Provider Business Mailing Address
First Line	:	5352 N LINCOLN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-2316
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1952 E 73RD ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60649-2902
Country	:	US
Telephone Number	:	773-493-4444
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MOHAMMAD KHAMIS
Credential	:
Telephone Number	:	773-353-5047

Provider Enumeration Date	:	10/29/2018
Last Update Date	:	10/29/2018

Similar Medicare Providers

1154465664 — DR. KUMAR M KALIANA M.D.
Practice Location Address:

1952 E 73RD ST
CHICAGO, IL
60649-2902

Practice Phone: 773-493-5600
Practice Fax: 773-493-5790

1083730733 — DR. CHARLES E. GREER D.N.
Practice Location Address:

1970 E 73RD ST
CHICAGO, IL
60649-2902

Practice Phone: 773-308-4412
Practice Fax:

1245497346 — KALIANA MEDICAL SERVICES, LTD
Practice Location Address:

1952 E 73RD ST
CHICAGO, IL
60649-2902

Practice Phone: 773-493-5600
Practice Fax: 773-493-5790

1104070648 — KHANLTD
Practice Location Address:

1952 E 73RD ST
CHICAGO, IL
60649-2902

Practice Phone: 773-947-8664
Practice Fax:

1235625138 — NORTHWEST MEDICAL AND URGENT CARE CENTER AT SOUTH SHORE LLC
Practice Location Address:

1952 E 73RD ST
CHICAGO, IL
60649-2902

Practice Phone: 773-493-5600
Practice Fax:

1518949692 — I.F.OPTICAL CO., INC.
Practice Location Address:

2812 W TOUHY AVE
CHICAGO, IL
60645-2902

Practice Phone: 773-761-8969
Practice Fax: 773-761-3601

Directions to “LUNA PHARMACY AT SOUTH SHORE LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.