111th Pharma-Family
111th Pharma-Family is a Health Service Clinic/Center in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2012.
- Licensed in
- IL
- In the registry since
- 2012
Practice location Address checks out
11101 S State StChicago, IL 60628-4206
Phone: (708) 503-9845
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Health Service Clinic/Center (primary) | Taxonomy 261QH0100X · Licence 051035317 (IL) |
|---|
Record details
| NPI number | 1659616175 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Adele Vanjackson — Owner/Pharmacist · (708) 503-9845 |
| NPI enumerated | December 10, 2012 |
| Last updated in NPPES | December 10, 2012 |
| Mailing address | 11101 S State St, Chicago, IL 60628-4206 |
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