MEDICARE: KHUTEJA BEGUM PHARMACIST

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	051298203	IL

General Provider Information

NPI Number	:	1477145704
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KHUTEJA BEGUM PHARMACIST

Provider Business Mailing Address
First Line	:	1041 W GOLF RD
Second Line	:
City	:	HOFFMAN ESTATES
State	:	IL
Zip	:	60169-1339
Country	:	US
Telephone Number	:	847-764-8992
Fax Number	:	847-764-8993

Provider Business Practice Location Address
First Line	:	1041 W GOLF RD
Second Line	:
City	:	HOFFMAN ESTATES
State	:	IL
Zip	:	60169-1339
Country	:	US
Telephone Number	:	847-764-8992
Fax Number	:	847-764-8993

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

Provider Enumeration Date	:	02/08/2021
Last Update Date	:	02/08/2021

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