Healthcare Provider Details

I. General information

NPI: 1881691830
Provider Name (Legal Business Name): SARJ USA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2005
Last Update Date: 11/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2735B W NORTH AVE
CHICAGO IL
60647-5246
US

IV. Provider business mailing address

2735B W NORTH AVE
CHICAGO IL
60647-5246
US

V. Phone/Fax

Practice location:
  • Phone: 773-278-5337
  • Fax: 773-278-5365
Mailing address:
  • Phone: 773-278-5337
  • Fax: 773-278-5365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number054-014351
License Number StateIL

VIII. Authorized Official

Name: MR. JATIN PATEL
Title or Position: PHARMACIST
Credential: RPH
Phone: 773-278-5337