GSK Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

054.012049 Issued in IL

Legal business name

GSK PHARMACY INC

Doing business as

GSK PHARMACY INC

Practice address

5140 W Chicago Ave
Chicago, IL 60651-2903

Phone

(773) 287-1078

Fax

(847) 699-9767

NPI assigned

Dec 13, 2006

Organization subpart

No

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

Authorized official

Name

Pravin Khatri, RPH

Title

President

Phone

(773) 287-1078

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• GSK PHARMACY INC Doing business as

Locations

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447027200000",
    "number": "1679634497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5140 W CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606512903",
            "telephone_number": "773-287-1078",
            "fax_number": "847-699-9767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5140 W CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606512903",
            "telephone_number": "773-287-1078",
            "fax_number": "847-699-9767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GSK PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2015-11-09",
        "status": "A",
        "authorized_official_last_name": "KHATRI",
        "authorized_official_first_name": "PRAVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-287-1078",
        "authorized_official_credential": "RPH"
    },
    "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": "054.012049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2019825",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GSK PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Krystyna M Grzeskowiak, DDS
• Wojciech Zbigniew Grzeskowiak, MD
• Jennifer Grzybek, SLP
• Jacqueline Grzymala, MOR/L
• GSDC Inc
• Jiansan Gu, MD
• Seulgi Gu, MD
• Idalia Guachichullca
• Ivan Guadarrama
• Jocelyn Guadarrama

• 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 Nov 9, 2015; 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.