NPI 1003509019
Vivent Pharmacy Illinois LLC
Practice location
- Address
- 5537 N Broadway St STE 101, Chicago, IL 60640-1405
- Phone
- (888) 655-2078
- Fax
- (872) 813-4226
- Mailing address
- 1311 N 6th St STE 201, Milwaukee, WI 53212-4006
Authorised official
- Name
- Tony Fields
- Title
- Chief Pharmacy Officer
- Phone
- (414) 223-6874
Registered specialties (2)
Community/Retail Pharmacy
Primary
Pharmacy
Registry record
- NPI
- 1003509019
- Entity type
- Organization
- NPI issued
- 26 May 2023
- Record last updated
- 8 Apr 2024
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.