Korle Bu Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

54016112 Issued in IL

Legal business name

KORLE BU PHARMACY LLC

Doing business as

KORLE BU PHARMACY

Practice address

5517 S Michigan Ave
Chicago, IL 60637-1012

Phone

(773) 321-2656

Fax

(773) 667-9815

NPI assigned

Feb 2, 2007

Organization subpart

No

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

Authorized official

Name

Prashant Patel, PHARM D

Title

Pharmicist in Charge

Phone

(847) 858-4776

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• KORLE BU PHARMACY Doing business as

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269388800000",
    "number": "1114065976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 OSPREY CT",
            "city": "STREAMWOOD",
            "state": "IL",
            "postal_code": "601072813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5517 S MICHIGAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371012",
            "telephone_number": "773-321-2656",
            "fax_number": "773-667-9815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KORLE BU PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2010-03-24",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "PRASHANT",
        "authorized_official_title_or_position": "PHARMICIST IN CHARGE",
        "authorized_official_telephone_number": "847-858-4776",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "54016112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1480350",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KORLE BU PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Asha E Koritala, CCC-SLP
• Jason Kenneth Korkus, D.D.S.
• Jeffery John Korkus III, D.D.S.
• Kavya Korlapati
• Korle Bu Medical Group
• Amir Korman Inbal, M.D
• Sherri Korman, M.D.
• Mary Joanne Korn, P.T.
• Caroline Grace Kornak
• Korneal Kontax

• Community/Retail Pharmacy in Chicago, IL
• Providers in Chicago, IL by specialty
• Community/Retail Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2010; 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.