NPIMap

Organization Active NPI

Gottlieb Memorial Hospital

Doing business as Gottlieb Professional Building Pharmacy

  • Pharmacy
  • Melrose Park, IL
National Provider Identifier
1124005517
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
054008713 Issued in IL
Legal business name
GOTTLIEB MEMORIAL HOSPITAL
Doing business as
Gottlieb Professional Building Pharmacy
Practice address
675 W North Ave
Melrose Park, IL 60160-1634
Phone
(708) 450-4941
Fax
(708) 681-4673
NPI assigned
Dec 27, 2005
Organization subpart
Yes
Parent organization
GOTTLIEB MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

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

Authorized official

Name
Ms. Adenrele Adekunbi Kolawole
Title
Director Billing Operations
Phone
(708) 216-3743

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 054008713 IL Primary

Addresses

Primary practice location

675 W North Ave
Melrose Park, IL 60160-1634

Mailing address

701 W North Ave
Melrose Park, IL 60160-1612
Phone (708) 450-4941

Other names 1

  • Gottlieb Professional Building Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Gottlieb Memorial Hosp5 organizations share this tax ID, including this one
Part of
Gottlieb Memorial Hosp

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605484800000",
    "number": "1124005517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 W NORTH AVE",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601612",
            "telephone_number": "708-450-4941",
            "fax_number": "708-681-4673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 W NORTH AVE",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601634",
            "telephone_number": "708-450-4941",
            "fax_number": "708-681-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOTTLIEB MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GOTTLIEB MEMORIAL HOSPITAL",
        "enumeration_date": "2005-12-27",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A",
        "authorized_official_last_name": "KOLAWOLE",
        "authorized_official_first_name": "ADENRELE",
        "authorized_official_middle_name": "ADEKUNBI",
        "authorized_official_title_or_position": "DIRECTOR BILLING OPERATIONS",
        "authorized_official_telephone_number": "708-216-3743",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IL",
            "license": "054008713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gottlieb Professional Building Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Melrose Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; 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.