MEDICARE: MR. SUDHIR C MANEK R.PH.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist		IL

General Provider Information

NPI Number	:	1467553701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SUDHIR C MANEK R.PH.

Provider Business Mailing Address
First Line	:	23W271 HAMPTON CIR
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60540-9424
Country	:	US
Telephone Number	:	630-961-8223
Fax Number	:	630-820-6864

Provider Business Practice Location Address
First Line	:	475 N FARNSWORTH AVE
Second Line	:
City	:	AURORA
State	:	IL
Zip	:	60505-3004
Country	:	US
Telephone Number	:	630-820-3360
Fax Number	:	630-820-6864

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	07/08/2007

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