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FULLERTON KEDZIE PROFESSIONAL PHARMACY
NPI 1083005078
Pharmacy - Community/Retail Pharmacy in Chicago, IL

Active since February 11, 2015
3153 W FULLERTON AVE, CHICAGO, IL 60647(773) 278-6604(773) 395-4633 Get Directions Write a Review

NPPES record last updated: February 11, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Fullerton Kedzie Professional Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FULLERTON KEDZIE PROFESSIONAL PHARMACY (NPI 1083005078) is a healthcare organization registered as a community/retail pharmacy in Chicago, Illinois and active in the NPI registry since February 2015. The organization lists Ettore Boggetto, Pharmacist-in-charge, as its authorized official.

NPPES Registry Identity

NPI1083005078
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameFULLERTON KEDZIE PROFESSIONAL PHARMACY
Location Address3153 W FULLERTON AVEChicago, IL 60647-2809
Mailing Address3153 W Fullerton AveChicago, IL 60647-2809 · (773) 278-6604 · Fax (773) 395-4633
Phone(773) 278-6604
Fax(773) 395-4633
Organization SubpartNo
Authorized OfficialEttore BoggettoPharmacist-in-charge · (773) 278-6604
Enumeration DateFebruary 11, 2015
✔ NPI 1083005078 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in IL · 054-007134
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
3153 W FULLERTON AVE, Chicago, IL 60647
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Other Identifiers 1

Medicaid355363043002IL

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CARA MARIE RODRIGUEZ PA-C
Physician Assistant
3153 W FULLERTON AVE
CHICAGO, IL 60647
Cook County (773) 395-4600
DR. PAUL A PLADZIEWICZ DDS
Dentist
3153 W FULLERTON AVE, FULLERTON/KEDZIE DENTAL GROUP
CHICAGO, IL 60647
Cook County (773) 278-6604
HAROLD JAIMES, M.D. P.C
Internal Medicine
3153 W FULLERTON AVE
CHICAGO, IL 60647
Cook County (773) 395-4600
BETTY N INGENTE PHARMACIST
Pharmacist
3153 W FULLERTON AVE
CHICAGO, IL 60647
Cook County (773) 278-6604
RICHARD MONTES PA-C
Physician Assistant
3153 W FULLERTON AVE
CHICAGO, IL 60647
Cook County (773) 395-4600
MR. ETTORE BOGGETTO
Pharmacist
3153 W FULLERTON AVE
CHICAGO, IL 60647
Cook County (773) 278-6604
HAROLD JAIMES M.D.
Internal Medicine
3153 W FULLERTON AVE
CHICAGO, IL 60647
Cook County (773) 395-4600
MANUEL MONTES DE OCA MD PC
Internal Medicine
3153 W FULLERTON AVE
CHICAGO, IL 60647
Cook County (773) 395-4600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fullerton Kedzie Professional Pharmacy's NPI number?

The NPI number for Fullerton Kedzie Professional Pharmacy is 1083005078. It was assigned to this organization in the NPPES registry on February 11, 2015.

Where is Fullerton Kedzie Professional Pharmacy located?

Fullerton Kedzie Professional Pharmacy is located at 3153 W Fullerton Ave, Chicago, IL 60647. The listed phone number is (773) 278-6604.

What is Fullerton Kedzie Professional Pharmacy's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

When was this NPI record last updated?

The NPPES record for Fullerton Kedzie Professional Pharmacy was last updated on February 11, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.