Provider Demographics
NPI:1801837315
Name:RX INNOVATIONS OF AMERICA
Entity Type:Organization
Organization Name:RX INNOVATIONS OF AMERICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:MS
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:KERSTEN
Authorized Official - Suffix:
Authorized Official - Credentials:REG PHARMACIST
Authorized Official - Phone:312-739-1186
Mailing Address - Street 1:77 E MONROE ST
Mailing Address - Street 2:SUITE 420
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60603-5905
Mailing Address - Country:US
Mailing Address - Phone:312-739-1186
Mailing Address - Fax:312-739-1187
Practice Address - Street 1:77 E MONROE ST
Practice Address - Street 2:SUITE 420
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60603-5905
Practice Address - Country:US
Practice Address - Phone:312-739-1186
Practice Address - Fax:312-739-1187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILBR7422330OtherDEA #