MEDICARE: MONIK PHARMACY, 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	333600000X	Pharmacy

General Provider Information

NPI Number	:	1477723369
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONIK PHARMACY, INC

Provider Business Mailing Address
First Line	:	2266 N. LINCOLN AVE LL
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614
Country	:	US
Telephone Number	:	773-880-9045
Fax Number	:	773-880-9065

Provider Business Practice Location Address
First Line	:	2266 N. LINCOLN AVE LL
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614
Country	:	US
Telephone Number	:	773-880-9045
Fax Number	:	773-880-9065

Authorized Official
Title or Position	:	PHARMACIST
Name	:	MR. MOHSIN M MERCHANT
Credential	:	R.PH
Telephone Number	:	773-880-9045

Provider Enumeration Date	:	03/06/2008
Last Update Date	:	04/01/2019

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