Midwest Specialty Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

054020297 Issued in IL

Legal business name

MIDWEST SPECIALTY PHARMACY LLC

Practice address

712 N Dearborn St
Ste. 3a
Chicago, IL 60654-3846

Phone

(312) 690-4585

Fax

(312) 690-4575

NPI assigned

Apr 5, 2017

Organization subpart

No

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

Authorized official

Name

Fedja Temim

Title

Director

Phone

(312) 690-4585

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Midwest Specialty Pharmacy LLC Doing business as

Locations

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

{
    "created_epoch": "1491350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491350400000",
    "number": "1578096749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 N DEARBORN ST",
            "address_2": "STE. 3A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606543846",
            "telephone_number": "312-690-4585",
            "fax_number": "312-690-4575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 N DEARBORN ST",
            "address_2": "STE. 3A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606543846",
            "telephone_number": "312-690-4585",
            "fax_number": "312-690-4575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST SPECIALTY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-05",
        "last_updated": "2017-04-05",
        "status": "A",
        "authorized_official_last_name": "TEMIM",
        "authorized_official_first_name": "FEDJA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "312-690-4585"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054020297",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2168676",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midwest Specialty Pharmacy LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• 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 Apr 5, 2017; 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.