MEDICARE: OAK LAWN PHARMACY 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	:	1134934441
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OAK LAWN PHARMACY LLC

Provider Business Mailing Address
First Line	:	8712 RIDGELAND AVE
Second Line	:
City	:	OAK LAWN
State	:	IL
Zip	:	60453-1068
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8712 RIDGELAND AVE
Second Line	:
City	:	OAK LAWN
State	:	IL
Zip	:	60453-1068
Country	:	US
Telephone Number	:	708-856-5532
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	YOUSEF QASEM
Credential	:
Telephone Number	:	708-856-5532

Provider Enumeration Date	:	02/12/2025
Last Update Date	:	02/12/2025

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Directions to “OAK LAWN PHARMACY LLC ” Practice Location

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