Convex Pharmacy, LLC

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

054.018565 Issued in IL

Legal business name

CONVEX PHARMACY, LLC

Practice address

14400 John Humphrey Dr
Suite 110
Orland Park, IL 60462-2897

Phone

(708) 460-4930

Fax

(708) 460-4932

NPI assigned

May 7, 2013

Organization subpart

No

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

Authorized official

Name

Maryam Alrazzaq, PHARM DNPI 1013287705

Title

President / Owner

Phone

(708) 460-4930

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Convex Pharmacy Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Maryam A Alrazzaq, PHARMD

  • Pharmacist
  • Orland Park, IL
  • NPI 1013287705
  NPD (past) Authorized official
• Thao Pham, PHARM.D

  • Pharmacist
  • Orland Park, IL
  • NPI 1679958417
  NPD (past)

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

{
    "created_epoch": "1367884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613088000000",
    "number": "1679918403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14400 JOHN HUMPHREY DR",
            "address_2": "SUITE 110",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604622897",
            "telephone_number": "708-460-4930",
            "fax_number": "708-460-4932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14400 JOHN HUMPHREY DR",
            "address_2": "SUITE 110",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604622897",
            "telephone_number": "708-460-4930",
            "fax_number": "708-460-4932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONVEX PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-07",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A",
        "authorized_official_last_name": "ALRAZZAQ",
        "authorized_official_first_name": "MARYAM",
        "authorized_official_title_or_position": "PRESIDENT / OWNER",
        "authorized_official_telephone_number": "708-460-4930",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "IL",
            "license": "054.018565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2140286",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Convex Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cory L Conniff, MD
• Jayne Connors
• Michael Robert Conrad, RPH
• Michelle Conrad, LCPC
• Consol High School Dist 230
• Courtney Conway, OTR
• Karen D Cook, PHARMD
• Coping Together
• Coping Together Services
• Coping Together Services

• Compounding Pharmacy in Orland Park, IL
• Providers in Orland Park, IL by specialty
• Compounding Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2021; 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.