Healthcare Provider Details

I. General information

NPI: 1548164130
Provider Name (Legal Business Name): ANANDA ANDERSON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 WILMOT RD
DEERFIELD IL
60015-4620
US

IV. Provider business mailing address

5320 N SHERIDAN RD APT 2008
CHICAGO IL
60640-7348
US

V. Phone/Fax

Practice location:
  • Phone: 847-404-7587
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051309399
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: