Mymed Pharmacy Inc

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

054019958 Issued in IL

Legal business name

MYMED PHARMACY INC

Practice address

9838 S Roberts Rd Ste 6
Palos Hills, IL 60465-1547

Phone

(708) 576-8580

Fax

(708) 529-3412

NPI assigned

Jun 10, 2016

Organization subpart

No

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

Authorized official

Name

John Elzaibak

Title

Manager

Phone

(708) 576-8580

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mymed Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1465516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466035200000",
    "number": "1396194239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9838 S ROBERTS RD STE 6",
            "city": "PALOS HILLS",
            "state": "IL",
            "postal_code": "604651547",
            "telephone_number": "708-576-8580",
            "fax_number": "708-529-3412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9838 S ROBERTS RD STE 6",
            "city": "PALOS HILLS",
            "state": "IL",
            "postal_code": "604651547",
            "telephone_number": "708-576-8580",
            "fax_number": "708-529-3412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYMED PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-10",
        "last_updated": "2016-06-16",
        "status": "A",
        "authorized_official_last_name": "ELZAIBAK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "708-576-8580"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "IL",
            "license": "054019958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2160563",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mymed Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Carrie Murray, OTR/L
• Pedro M Nadela, PT
• Ahmad Naeem
• Shanta Nair, M.D.
• Caitlin Nelson, SLP
• Kelly Marie Newcomb, COTA

• Compounding Pharmacy in Palos Hills, IL
• Providers in Palos Hills, IL by specialty
• Compounding Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2016; 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.