Provider Demographics
NPI:1164786554
Name:XPRESS PHARMACY INC
Entity Type:Organization
Organization Name:XPRESS PHARMACY INC
Other - Org Name:XPRESS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEMA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALZEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-598-5000
Mailing Address - Street 1:6700 W 95TH ST
Mailing Address - Street 2:SUITE 150
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2199
Mailing Address - Country:US
Mailing Address - Phone:708-598-5000
Mailing Address - Fax:708-598-6737
Practice Address - Street 1:6700 W 95TH ST
Practice Address - Street 2:SUITE 150
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2199
Practice Address - Country:US
Practice Address - Phone:708-598-5000
Practice Address - Fax:708-598-6737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-29
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X, 3336S0011X
IL0540198453336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2136441OtherPK
IL900874200001Medicaid