Active NPI
Surecare 2 Inc.
- Community/Retail Pharmacy
- Chicago, IL
National Provider Identifier
1053996249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- SURECARE 2 INC.
- Practice address
- 4104 W 63Rd St Ste 1
Chicago, IL 60629-5008 - Phone
- (708) 350-5252
- Fax
- (708) 350-5255
- NPI assigned
- Mar 10, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Rachit Shah, RPH
- Title
- Pharmacy Incharge
- Phone
- (708) 350-5252
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
4104 W 63Rd St Ste 1
Chicago, IL 60629-5008
Mailing address
4104 W 63Rd St Ste 1
Chicago, IL 60629-5008
Phone (708) 350-5252
Other names 1
- Surecare pharmacy chicago
National Provider Directory
National Provider DirectoryLocations
4104 W 63rd St
#1
Chicago, IL 60629
Phone (708) 350-5252
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- South Barrington, IL
- NPI 1629622840
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615334400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1712880000000",
"number": "1053996249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4104 W 63RD ST STE 1",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606295008",
"telephone_number": "708-350-5252",
"fax_number": "708-350-5255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4104 W 63RD ST STE 1",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606295008",
"telephone_number": "708-350-5252",
"fax_number": "708-350-5255"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SURECARE 2 INC.",
"organizational_subpart": "NO",
"enumeration_date": "2021-03-10",
"last_updated": "2024-04-12",
"certification_date": "2023-12-13",
"status": "A",
"authorized_official_last_name": "SHAH",
"authorized_official_first_name": "RACHIT",
"authorized_official_title_or_position": "PHARMACY INCHARGE",
"authorized_official_telephone_number": "708-350-5252",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Surecare pharmacy chicago",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.