Provider Demographics
NPI:1821362369
Name:RXPERTS PHARMACY - CHICAGO, LLC
Entity type:Organization
Organization Name:RXPERTS PHARMACY - CHICAGO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:GIBBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-656-0882
Mailing Address - Street 1:6227 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:MORTON GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60053-2636
Mailing Address - Country:US
Mailing Address - Phone:847-583-1717
Mailing Address - Fax:847-583-1818
Practice Address - Street 1:6227 PARK AVE
Practice Address - Street 2:
Practice Address - City:MORTON GROVE
Practice Address - State:IL
Practice Address - Zip Code:60053-2636
Practice Address - Country:US
Practice Address - Phone:847-583-1717
Practice Address - Fax:847-583-1818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-01
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL054-0178573336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy