Provider Demographics
NPI:1992817837
Name:MHAJ INVESTMENTS LLC
Entity type:Organization
Organization Name:MHAJ INVESTMENTS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:MRS
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHLOSS DE BRIHUEGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-973-6107
Mailing Address - Street 1:6420 N CALIFORNIA AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-5253
Mailing Address - Country:US
Mailing Address - Phone:773-973-6107
Mailing Address - Fax:773-973-7580
Practice Address - Street 1:6420 N CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-5253
Practice Address - Country:US
Practice Address - Phone:773-973-6107
Practice Address - Fax:773-973-7580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
IL0540098823336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2019302OtherPK
IL363707788001Medicaid
4595840001Medicare NSC