Ivan T Matthei Pharmacy

LBN: 29 E Madison Corp
Ivan T Matthei Pharmacy is an health care organization with primary practice located at 25 E Washington St Lowr 53 Lower Level Pedway, Chicago IL 60602-1736. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. 29 E Madison Corp can be contacted via phone (312) 263-7194, or through Edelheit, Mark via phone (312) 263-7194.

Contact Information

Primary practice address
25 E Washington St Lowr 53 Lower Level Pedway Chicago IL 60602-1736
Phone: (312) 263-7194
Fax: (312) 263-7636
Website:
Map and Directions
Authorized official contact:
Name: Edelheit, Mark RPH
Phone: (312) 263-7194

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X 054013583 Illinois

Profile Details

NPI number 1497837009
LBN Legal business name 29 E Madison Corp
DBA Doing business as Ivan T Matthei Pharmacy
Authorized official Edelheit, Mark RPH
Entity Organization
Organization subpart 1 No
Enumeration date Oct 20th, 2006
Last updated Mar 9th, 2010 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497837009 NPPES
Illinois MEDICAID 6060201
Illinois Other 1449948

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