Ravenswood Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

054017816 Issued in IL

Legal business name

RAVENSWOOD PHARMACY INC

Doing business as

Ravenswood Pharmacy INC.

Practice address

1945 W Wilson Ave Ste 102
Chicago, IL 60640-5255

Phone

(773) 561-8048

Fax

(773) 561-8084

NPI assigned

Dec 8, 2011

Last updated

Mar 16, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sameh Attia

Title

Pic

Phone

(773) 612-2517

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Ravenswood Pharmacy INC. Doing business as

Locations

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

{
    "created_epoch": "1323302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331856000000",
    "number": "1255609905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1945 W WILSON AVE STE 102",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405255",
            "telephone_number": "773-561-8048",
            "fax_number": "773-561-8084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 W WILSON AVE STE 102",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405255",
            "telephone_number": "773-561-8048",
            "fax_number": "773-561-8084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAVENSWOOD PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-08",
        "last_updated": "2012-03-16",
        "status": "A",
        "authorized_official_last_name": "ATTIA",
        "authorized_official_first_name": "SAMEH",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "773-612-2517"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054017816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1486302",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ravenswood Pharmacy INC.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ravenswood Dental PLLC
• Ravenswood Family Practice
• Ravenswood Health and Wellness Center, S.C.
• Ravenswood Health Center, P.C.
• Ravenswood Pediatrics SC
• Ravenswood Physician Associates
• Ravenswood SLF, LLC
• Ravi Badlani MDSC
• Arun Ravi
• Sai Susmitha Ravi

• 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 16, 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.