Moon Lake Pharmacy, Inc.

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

MOON LAKE PHARMACY, INC.

Practice address

1399 W Schaumburg Rd
Schaumburg, IL 60194-4134

Phone

(847) 895-3900

NPI assigned

May 24, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Marc Yanow, R.PH.

Title

President

Phone

(847) 895-3900

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841293719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1399 W SCHAUMBURG RD",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601944134",
            "telephone_number": "847-895-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1399 W SCHAUMBURG RD",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601944134",
            "telephone_number": "847-895-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOON LAKE PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "YANOW",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-895-3900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clemencia Molano
• Melissa Molitor
• Roanelee Monje
• Rebecca Eaton Montgomery, DDS
• Laura Monti, PH.D.
• Jung H Moon, DPM
• Moon'S Multi Specialty Clinic, SC
• Elizabeth Moore, FNP-C
• Sitlaly Morales Garcia
• Yazmin Moran

• Pharmacy in Schaumburg, IL
• Providers in Schaumburg, IL by specialty
• Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.