Provider Demographics
NPI:1811341753
Name:ARDEE PHARMACY INC
Entity type:Organization
Organization Name:ARDEE PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:L
Authorized Official - Last Name:EINBINDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-246-8493
Mailing Address - Street 1:1505 W DEVON AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-1313
Mailing Address - Country:US
Mailing Address - Phone:872-208-5255
Mailing Address - Fax:847-566-7288
Practice Address - Street 1:1505 W DEVON AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60660-1313
Practice Address - Country:US
Practice Address - Phone:872-208-5255
Practice Address - Fax:847-566-7288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-18
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0540195543336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
054019554OtherSTATE OF ILLINOIS LICENSE NUMBER