Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Fullerton Kedzie Professional Pharmacy

Organization Community/Retail Pharmacy · NPI 1083005078

Fullerton Kedzie Professional Pharmacy is a Community/Retail Pharmacy in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2015.

Licensed in
IL
In the registry since
2015

Practice location Address checks out

3153 W Fullerton Ave
Chicago, IL 60647-2809
Phone: (773) 278-6604
Fax: (773) 395-4633
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Retail Pharmacy (primary) Taxonomy 3336C0003X · Licence 054-007134 (IL)

Record details

NPI number1083005078
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ettore Boggetto — Pharmacist-In-Charge · (773) 278-6604
NPI enumeratedFebruary 11, 2015
Last updated in NPPESFebruary 11, 2015
Mailing address3153 W Fullerton Ave, Chicago, IL 60647-2809

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