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

Life Source Pharmacy Inc

Organization Durable Medical Equipment & Medical Supplies · NPI 1821316647

Life Source Pharmacy Inc is a Durable Medical Equipment & Medical Supplies in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2010.

Licensed in
IL
In the registry since
2010
Specialties on file
3
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

11238 S Western Ave
Chicago, IL 60643-4116
Phone: (773) 321-2656
Fax: (773) 941-4294
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Retail Pharmacy (primary) Taxonomy 3336C0003X · Licence 054-017353 (IL)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X
Pharmacy Taxonomy 333600000X

Record details

NPI number1821316647
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Prashant Patel — President · (773) 321-2656
Other names Life Source Pharmacy, Inc
NPI enumeratedMay 5, 2010
Last updated in NPPESMarch 22, 2015
Mailing address5 Osprey Ct, Streamwood, IL 60107-2813

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