Provider profile · NPI 1205354628

5 Cs

Pharmacist · Chicago, IL · NPI 1205354628 · No federal exclusion match

✔ Verified against the public CMS NPPES registry & HHS-OIG LEIE as of Jun 21, 2026. Source-linked, daily-refreshed. Public data only — no PHI.

Registry details

Type

Organization

Primary specialty

Pharmacist

Enumerated

Sep 6, 2017

License(s)

051.287455 (IL)

Addresses on file

PurposeAddressCity/StatePhone
MAILING10830 S HALSTED ST Chicago, IL 60628-3126773-468-0223
LOCATION10830 S HALSTED ST Chicago, IL 60628773-468-0223

View on NPPES registry ↗

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