Provider Demographics
NPI:1881065480
Name:INSTANTPHARMACY LLC
Entity type:Organization
Organization Name:INSTANTPHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:OPEYEMI
Authorized Official - Middle Name:
Authorized Official - Last Name:OYELAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-978-5514
Mailing Address - Street 1:22048 EMILY LN
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-7816
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21000 S FRANKFORT SQUARE RD
Practice Address - Street 2:SUITE M
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-9385
Practice Address - Country:US
Practice Address - Phone:815-534-5813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-08
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0540188703336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL054018870OtherSTATE LICENSE