MEDICARE: GORDONO PHARMACY

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
2	333600000X	Pharmacy		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1453480	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164437778
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GORDONO PHARMACY

Provider Business Mailing Address
First Line	:	5501 N CLARK ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-1213
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5501 N CLARK ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-1213
Country	:	US
Telephone Number	:	773-561-3671
Fax Number	:	773-728-1399

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JEFF BENDIX
Credential	:
Telephone Number	:	773-561-3671

Provider Enumeration Date	:	07/30/2006
Last Update Date	:	09/11/2025

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Directions to “GORDONO PHARMACY ” Practice Location

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