Provider Demographics
NPI:1225446974
Name:DUNDEE PHARMACY INC
Entity Type:Organization
Organization Name:DUNDEE PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:A
Authorized Official - Last Name:MACKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:847-480-1000
Mailing Address - Street 1:2750 DUNDEE RD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2600
Mailing Address - Country:US
Mailing Address - Phone:847-480-1000
Mailing Address - Fax:847-480-1988
Practice Address - Street 1:2750 DUNDEE RD
Practice Address - Street 2:SUITE 9
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2600
Practice Address - Country:US
Practice Address - Phone:847-480-1000
Practice Address - Fax:847-480-1988
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DUNDEE PHARMACY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-07-25
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0146530001Medicare NSC