OrganizationActive
111th Pharma-Family
NPI 1659616175 · Health Service Clinic/Center · Chicago, IL
Provider details
- NPI number
- 1659616175
- Entity type
- Organization
- Primary specialty
- Health Service Clinic/CenterAmbulatory Health Care Facilities
- Authorized official
- Adele Vanjackson, Owner/Pharmacist
- License
- 051035317 (IL)
Mailing address
11101 S State St
Chicago, IL 60628-4206
Registry dates
- Enumerated
- 2012-12-10
- Last updated
- 2012-12-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.