1609634245 NPI number — CIMPAR PHARMACY OAK PARK, LLC

Table of content: (NPI 1609634245)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609634245 NPI number — CIMPAR PHARMACY OAK PARK, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CIMPAR PHARMACY OAK PARK, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609634245
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/02/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
12/22/2025
NPI Reactivation Date:
02/02/2026

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
101 MADISON ST
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
OAK PARK
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60302
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
773-270-9440
Provider Business Mailing Address Fax Number:
773-270-9441

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101 MADISON ST
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
OAK PARK
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60302-4210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-423-5593
Provider Business Practice Location Address Fax Number:
708-486-2702
Provider Enumeration Date:
03/08/2024

Additional Information

Authorized Official

Authorized Official Last Name:
ROMAN
Authorized Official First Name:
DAN
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF FINANCIAL & OPERATING OFFICER
Authorized Official Telephone Number:
773-415-4030

Provider Taxonomy Codes

  • Taxonomy code: 3336L0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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