FORUM EXTENDED CARE SVC INC II (NPI# 1346291499) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346291499 |
| Entity Type | Organization |
| Organization Name | FORUM EXTENDED CARE SVC INC II |
| Other Organization Name | FORUM EXTENDED CARE SVC INC II |
| Practice Address |
4201 W Victoria St Chicago IL 60646-6700 |
| Practice Telephone | 8476738727 |
| Practice Fax Number | 8476736215 |
| Mailing Telephone | 8476738727 |
| Mailing Fax Number | 8476736215 |
| Enumeration Date | 2006-05-13 |
| Last Update Date | 2016-03-03 |
| Authorized Official Name | BRIAN KRAMER (PRESIDENT) |
| Authorized Official Telephone | 8476738727 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
| N | 333600000X | Pharmacy | 64001297A | IN | Suppliers |
| N | 3336H0001X |
Pharmacy Specialization: Home Infusion Therapy Pharmacy |
Suppliers | ||
| N | 3336I0012X |
Pharmacy Specialization: Institutional Pharmacy |
1204-43 | WI | Suppliers |
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
054017240 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201063520 A | 05 | |
| WI | 33245400 | 05 | |
| IL | 36855933001 | 05 | |
| PK | 2022130 | 01 |
| Other Name | Type Code |
|---|---|
| FORUM EXTENDED CARE SVC INC II | Doing Business As Name - Organization |
| Street Address |
4201 W VICTORIA ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60646-6700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134217623 | Brian H Kramer | Pharmacist | 4201 W Victoria St, Chicago, IL 60646-6700 | 2006-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801312087 | Manal Ibrahim | Dentist | 6228 N Keystone Ave, Chicago, IL 60646 | 2017-08-18 |
| 1750820742 | Kaitlin O'brien | Student in an Organized Health Care Education/Training Program | 5801 N Pulaski, Chicago, IL 60646 | 2017-02-23 |
| 1659810646 | Sofia Trani | Student in an Organized Health Care Education/Training Program | 5801 N. Pulaski Rd, Chicago, IL 60646 | 2017-02-23 |
| 1487191151 | Ronald E. Rysztogi | Naprapath | 5704 N. Austin, Chicago, IL 60646 | 2017-01-19 |
| 1417403148 | Joyful Dental Care | Clinic/Center | 6314 N. Cicero Avenue, Chicago, IL 60646 | 2016-09-01 |
| 1164889754 | Physicians At Call | Family Medicine | 5901 N. Cicero Ave, Ste 207, Chicago, IL 60646 | 2016-01-27 |
| 1245610617 | Arlett Payne | Physician Assistant | 5906 N Milwaukee, Chicago, IL 60646 | 2015-06-01 |
| 1811375843 | North River Mental Health Center | Community/Behavioral Health | 5801 North Pulaski Road, Chicago, IL 60646 | 2015-05-11 |
| 1003157298 | Family Choice Home Health | Homemaker | 5933 N Milwaukee Avenue, Chicago, IL 60646 | 2013-03-13 |
| 1235479593 | Antonina Skapars Trinkuns | Psychiatry & Neurology | 6404 N. Tahoma Ave., Chicago, IL 60646 | 2013-02-25 |
| Find all providers in zip 60646 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
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|---|---|---|---|---|
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| 1275588170 | Rosens Morseview Pharmacy Inc | Pharmacy | 2955 W Devon Ave, Chicago, IL 60659-1555 | 2006-05-23 |
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| 1295761401 | Procare Pharmaceuticals LLC | Pharmacy | 5061 N Pulaski Rd, Chicago, IL 60630-2706 | 2006-06-23 |
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| 1720574676 | Critical Care Rx, LLC | Pharmacy | 126 Oak St, Peoria, IL 61602 | 2018-07-03 |
| 1538672449 | Wear Ltc | Pharmacy | 527 N Madison St Ste B, Carthage, IL 62321-1034 | 2017-11-14 |
| 1124546031 | Symbria Rx Services, LLC. | Pharmacy | 3200 Grant St Rm 41, Evanston, IL 60201-1903 | 2017-08-31 |
| 1699146720 | Pharmblue Illinois LLC | Pharmacy | 2960 Chartres St Ste 100, La Salle, IL 61301-1097 | 2015-10-15 |
| 1194144691 | Lifemed Illinois, LLC | Pharmacy | 881 Il Route 83, Bensenville, IL 60106-1219 | 2014-04-11 |
| 1205250412 | Becks Long Term Care Pharmacy Inc | Pharmacy | 1413 Locust Street, Eldorado, IL 62930 | 2014-02-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.