MEDICARE: FARMACIA DE LAWNDALE INC

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	183500000X	Pharmacist	051034198	IL
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1366582421
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FARMACIA DE LAWNDALE INC

Provider Business Mailing Address
First Line	:	2621 S LAWNDALE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60623-4520
Country	:	US
Telephone Number	:	773-542-9595
Fax Number	:	773-542-9590

Provider Business Practice Location Address
First Line	:	2621 S LAWNDALE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60623-4520
Country	:	US
Telephone Number	:	773-542-9595
Fax Number	:	773-542-9590

Authorized Official
Title or Position	:	PHARMACIST-IN-CHARGE
Name	:	DR. AMY SHAH
Credential	:	PHARMD
Telephone Number	:	773-542-9595

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	05/08/2025

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Directions to “FARMACIA DE LAWNDALE INC ” Practice Location

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