Provider Demographics
NPI:1003555251
Name:SILVER PHARMACY, INC.
Entity Type:Organization
Organization Name:SILVER PHARMACY, INC.
Other - Org Name:SILVER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:NOURA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALAHMED
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:815-800-3100
Mailing Address - Street 1:2045 W GRAND AVE STE B #94702
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612
Mailing Address - Country:US
Mailing Address - Phone:815-800-3100
Mailing Address - Fax:815-800-3200
Practice Address - Street 1:1890 SILVER CROSS BLVD STE 120
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-9528
Practice Address - Country:US
Practice Address - Phone:815-800-3100
Practice Address - Fax:815-800-3200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-03
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL054022332OtherSTATE BOARD OF PHARMACY LICENSE