NPIMap

Organization Active NPI

Advocate Health and Hopsitals Corporation

Doing business as Christ Hospital Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Oak Lawn, IL
National Provider Identifier
1114063724
Registry record updated Dec 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
054008972 Issued in IL
Legal business name
ADVOCATE HEALTH AND HOPSITALS CORPORATION
Doing business as
Christ Hospital Outpatient Pharmacy
Practice address
4400 W 95TH St Ste 101
Department of Pharmacy
Oak Lawn, IL 60453-2655
Phone
(708) 684-5275
Fax
(708) 684-1712
NPI assigned
Jan 30, 2007
Last updated
Dec 5, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2012

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

Authorized official

Name
Mary Anne Hickman, PHARM D
Title
Pharmacy Supervisor
Phone
(708) 684-5275

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 054008972 IL Primary

Addresses

Primary practice location

4400 W 95TH St Ste 101
Department of Pharmacy
Oak Lawn, IL 60453-2655

Mailing address

4400 W 95TH St Ste 101
Department of Pharmacy
Oak Lawn, IL 60453-2655
Phone (708) 684-5275

Other identifiers 1

IdentifierTypeStateIssuer
1431698OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • CHRIST HOSPITAL OUTPATIENT PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lulla Sunil MD85 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 20

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 20

Locations

4400 W 95th St
Ste 101
Oak Lawn, IL 60453
Phone (708) 684-5275

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354665600000",
    "number": "1114063724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 W 95TH ST STE 101",
            "address_2": "DEPARTMENT OF PHARMACY",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532655",
            "telephone_number": "708-684-5275",
            "fax_number": "708-684-1712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 W 95TH ST STE 101",
            "address_2": "DEPARTMENT OF PHARMACY",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532655",
            "telephone_number": "708-684-5275",
            "fax_number": "708-684-1712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVOCATE HEALTH AND HOPSITALS CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2012-12-05",
        "status": "A",
        "authorized_official_last_name": "HICKMAN",
        "authorized_official_first_name": "MARY ANNE",
        "authorized_official_title_or_position": "PHARMACY SUPERVISOR",
        "authorized_official_telephone_number": "708-684-5275",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054008972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1431698",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHRIST HOSPITAL OUTPATIENT PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oak Lawn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; 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.