Organization Active NPI

Surecare 2 Inc.

  • Community/Retail Pharmacy
  • Chicago, IL
National Provider Identifier
1053996249
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
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

Updated by the provider on Apr 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Rachit Shah, RPHNPI 1629622840
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)CodeLicenseStatePrimary
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 Doing business as

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.