MEDICARE: JALAI SWOPE

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	051.306828	IL

General Provider Information

NPI Number	:	1841002177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JALAI SWOPE

Provider Business Mailing Address
First Line	:	3120 CHICAGO RD
Second Line	:
City	:	SOUTH CHICAGO HEIGHTS
State	:	IL
Zip	:	60411-5409
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3120 CHICAGO RD
Second Line	:
City	:	SOUTH CHICAGO HEIGHTS
State	:	IL
Zip	:	60411-5409
Country	:	US
Telephone Number	:	708-755-7972
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2025
Last Update Date	:	01/23/2025

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Directions to “ JALAI SWOPE ” Practice Location

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