Provider Demographics
NPI:1629213988
Name:CHICAGO MEDS LLC
Entity Type:Organization
Organization Name:CHICAGO MEDS LLC
Other - Org Name:UVANTA PHARMACY - NORTHERN ILINOIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEPALMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-297-9400
Mailing Address - Street 1:200 E HOWARD ST
Mailing Address - Street 2:SUITE 226
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60018
Mailing Address - Country:US
Mailing Address - Phone:847-297-9400
Mailing Address - Fax:847-297-9401
Practice Address - Street 1:200 E HOWARD ST
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60018
Practice Address - Country:US
Practice Address - Phone:847-297-9400
Practice Address - Fax:847-297-9401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-15
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL054.017149333600000X
3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2118265OtherPK