MEDICARE: MOON LAKE 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		IL

General Provider Information

NPI Number	:	1841293719
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOON LAKE PHARMACY, INC.

Provider Business Mailing Address
First Line	:	1399 W SCHAUMBURG RD
Second Line	:
City	:	SCHAUMBURG
State	:	IL
Zip	:	60194-4134
Country	:	US
Telephone Number	:	847-895-3900
Fax Number	:

Provider Business Practice Location Address
First Line	:	1399 W SCHAUMBURG RD
Second Line	:
City	:	SCHAUMBURG
State	:	IL
Zip	:	60194-4134
Country	:	US
Telephone Number	:	847-895-3900
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MARC YANOW
Credential	:	R.PH.
Telephone Number	:	847-895-3900

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	08/22/2020

Similar Medicare Providers

1295738177 — DR. THOMAS C BONUSO DDS
Practice Location Address:

1061 N SALEM DR
SCHAUMBURG, IL
60194-1331

Practice Phone: 847-882-8387
Practice Fax: 847-882-8450

1720085095 — MRS. PRETZEL A CENIZA PT
Practice Location Address:

2562 W SCHAUMBURG RD
SCHAUMBURG, IL
60194-3897

Practice Phone: 847-519-3485
Practice Fax: 847-519-3614

1730186586 — STEVEN N PECTOR D.O.
Practice Location Address:

2257 W SCHAUMBURG RD
SCHAUMBURG, IL
60194-3891

Practice Phone: 847-895-3583
Practice Fax: 847-895-3632

1093712846 — STEVEN N. PECTOR, D.O., LTD.
Practice Location Address:

2257 W SCHAUMBURG RD
SCHAUMBURG, IL
60194-3891

Practice Phone: 847-895-3583
Practice Fax: 847-895-3632

1467450783 — DRS. NELSON AND GARY DENTAL ASSOC. LTA
Practice Location Address:

1443 W SCHAUMBURG RD , STE 102
SCHAUMBURG, IL
60194-4065

Practice Phone: 847-895-4510
Practice Fax: 847-895-8834

1366434805 — DR. LEE ECHELBARGER D.C.
Practice Location Address:

740 E SCHAUMBURG RD
SCHAUMBURG, IL
60194-3508

Practice Phone: 847-781-9595
Practice Fax: 847-781-1799

Directions to “MOON LAKE PHARMACY, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.