Apotheco Pharmacy Decatur LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

APOTHECO PHARMACY DECATUR LLC

Practice address

17680 Kedzie Ave
Suite 104
Hazel Crest, IL 60429

Phone

(708) 957-4949

Fax

(708) 957-4968

NPI assigned

Nov 17, 2006

Last updated

May 30, 2025By 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

Anush Amin

Title

President

Phone

(973) 869-2820

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748563200000",
    "number": "1861565665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "788 MORRIS TPKE",
            "address_2": "SUITE 300",
            "city": "SHORT HILLS",
            "state": "NJ",
            "postal_code": "07078",
            "telephone_number": "973-869-2820",
            "fax_number": "973-369-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17680 KEDZIE AVE",
            "address_2": "SUITE 104",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "60429",
            "telephone_number": "708-957-4949",
            "fax_number": "708-957-4968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APOTHECO PHARMACY DECATUR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2025-05-30",
        "certification_date": "2021-02-08",
        "status": "A",
        "authorized_official_last_name": "AMIN",
        "authorized_official_first_name": "ANUSH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-869-2820"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "364403357001",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "=========",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP NUMBER",
            "identifier": "1459052",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Hazel Crest, IL
• Providers in Hazel Crest, 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 May 30, 2025; 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.