Cordant Pharmacy Illinois, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

CORDANT PHARMACY ILLINOIS, LLC

Doing business as

Cordant Pharmacy Solutions #R118

Practice address

8623 W Bryn Mawr Ave Ste 504
Chicago, IL 60631-3525

Phone

(872) 264-5673

NPI assigned

Oct 14, 2020

Organization subpart

Yes

Parent organization

CORDANT PHARMACY ILLINOIS, LLCAs reported in NPPES

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

Authorized official

Name

Fara Tippit

Title

Executive Assistant

Phone

(720) 272-3535

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Cordant Pharmacy Solutions #R118 Doing business as

Part of

Cordant Pharmacy Illinois LLC

Locations

Practitioners 1

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

• Jeffrey Daniel Grom, PHARMD

  • Pharmacist
  • Chicago, IL
  • NPI 1649525023
  NPD

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

{
    "created_epoch": "1602633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602633600000",
    "number": "1952909632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 W NORTHWEST HWY STE 100",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8623 W BRYN MAWR AVE STE 504",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313525",
            "telephone_number": "872-264-5673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORDANT PHARMACY ILLINOIS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CORDANT PHARMACY ILLINOIS, LLC",
        "enumeration_date": "2020-10-14",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A",
        "authorized_official_last_name": "TIPPIT",
        "authorized_official_first_name": "FARA",
        "authorized_official_title_or_position": "EXECUTIVE ASSISTANT",
        "authorized_official_telephone_number": "720-272-3535"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS BOARD OF PHARMACY",
            "identifier": "054.021576",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cordant Pharmacy Solutions #R118",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bridget Corcoran, PA
• Julia Corcoran, MD
• Katherine Corcoran, PHD
• Rosann M. Corcoran, L.C.S.W.
• Tim Corcoran, MD
• Laura Marie Cordaro
• Owen Cordaro, MD
• Anna Cordasco, APN
• Arnel Cordero
• Jennifer Cordero, RN

• Community/Retail Pharmacy in Chicago, IL
• Providers in Chicago, 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 Oct 14, 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.