Provider Demographics
NPI:1043486269
Name:MARK DRUGS NORTHSHORE INC
Entity Type:Organization
Organization Name:MARK DRUGS NORTHSHORE INC
Other - Org Name:MARK DRUGS NORTHSHORE INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:BATOGOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PHRMD
Authorized Official - Phone:630-699-2164
Mailing Address - Street 1:1020 MILWAUKEE AVE
Mailing Address - Street 2:STE 140
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-3513
Mailing Address - Country:US
Mailing Address - Phone:847-419-9898
Mailing Address - Fax:847-419-9899
Practice Address - Street 1:1020 MILWAUKEE AVE
Practice Address - Street 2:STE 140
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-3513
Practice Address - Country:US
Practice Address - Phone:847-419-9898
Practice Address - Fax:847-419-9899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-07
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0540163683336C0003X
3336C0004X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2023676OtherPK