MEDICARE: OAKMILL 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	333600000X	Pharmacy	054-16197	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1481100	OTHER	IL	NABP (NCPDP)

General Provider Information

NPI Number	:	1447441134
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OAKMILL PHARMACY, LLC

Provider Business Mailing Address
First Line	:	8118 N. MILWAUKEE AVE SUITE-104
Second Line	:
City	:	NILES
State	:	IL
Zip	:	60714-2817
Country	:	US
Telephone Number	:	847-518-0750
Fax Number	:	847-518-0427

Provider Business Practice Location Address
First Line	:	8118 N. MILWAUKEE AVE SUITE-104
Second Line	:
City	:	NILES
State	:	IL
Zip	:	60714-2817
Country	:	US
Telephone Number	:	847-518-0750
Fax Number	:	847-518-0427

Authorized Official
Title or Position	:	PHARMACIST
Name	:	JIGAR V DESAI
Credential	:	BACHOLOR SCIENCE
Telephone Number	:	847-518-0750

Provider Enumeration Date	:	08/07/2007
Last Update Date	:	06/11/2020

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