Del Lago Pharmacy LTD

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

054004961 Issued in IL

Legal business name

DEL LAGO PHARMACY LTD

Doing business as

Del Lago Pharmacy LTD

Practice address

1515 Sheridan Rd
Wilmette, IL 60091-1882

Phone

(847) 256-3950

Fax

(847) 256-3957

NPI assigned

Aug 18, 2006

Last updated

Apr 19, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Charles Bothschild, RPH

Title

Secretary

Phone

(847) 256-3950

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• DEL LAGO PHARMACY LTD Doing business as

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303171200000",
    "number": "1841304813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 SHERIDAN RD",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600911882",
            "telephone_number": "847-256-3950",
            "fax_number": "847-256-3957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 SHERIDAN RD",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600911882",
            "telephone_number": "847-256-3950",
            "fax_number": "847-256-3957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEL LAGO PHARMACY LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2011-04-19",
        "status": "A",
        "authorized_official_last_name": "BOTHSCHILD",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "847-256-3950",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054004961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1430204",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DEL LAGO PHARMACY LTD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Caitlin Davies, PHARMD
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• Community/Retail Pharmacy in Wilmette, IL
• Providers in Wilmette, 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 19, 2011; 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.