Provider Demographics
NPI:1790841724
Name:PROGRESTO INC
Entity Type:Organization
Organization Name:PROGRESTO INC
Other - Org Name:FARMACIA SAN JUDAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT CHIEF PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:D
Authorized Official - Last Name:ARCHIBALD
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:773-278-2333
Mailing Address - Street 1:3132 W NORTH AVE
Mailing Address - Street 2:FARMACIA SAN JUDAS
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-8415
Mailing Address - Country:US
Mailing Address - Phone:773-278-2333
Mailing Address - Fax:708-889-1769
Practice Address - Street 1:3132 W NORTH AVE
Practice Address - Street 2:FARMACIA SAN JUDAS
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-8415
Practice Address - Country:US
Practice Address - Phone:773-278-2333
Practice Address - Fax:708-889-1769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL054011952333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1465980OtherNABP
IL1465980OtherNABP