Organization Active NPI

Craigs Family Pharmacy Inc

  • Community/Retail Pharmacy
  • Glen Ellyn, IL
National Provider Identifier
1891869434
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
CRAIGS FAMILY PHARMACY INC
Practice address
401 N Main St
Glen Ellyn, IL 60137
Phone
(630) 469-1414
Fax
(630) 469-5214
NPI assigned
Nov 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Craig Adler Mandel, RPHNPI 1730224486
Title
President
Phone
(630) 469-1414

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X IL Primary

Addresses

Primary practice location

401 N Main St
Glen Ellyn, IL 60137

Mailing address

401 N Main St
Glen Ellyn, IL 60137
Phone (630) 469-1414

Other identifiers 1

IdentifierTypeStateIssuer
36364114001MedicaidIL

National Provider Directory

National Provider Directory

Locations

401 N Main St
Glen Ellyn, IL 60137
Phone (630) 469-1414

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891869434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N MAIN ST",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "60137",
            "telephone_number": "630-469-1414",
            "fax_number": "630-469-5214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N MAIN ST",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "60137",
            "telephone_number": "630-469-1414",
            "fax_number": "630-469-5214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAIGS FAMILY PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MANDEL",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "ADLER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-469-1414",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36364114001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Ellyn, IL

Sources for this page

  • 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.