Healthcare Provider Details

I. General information

NPI: 1619246790
Provider Name (Legal Business Name): ANISH PATEL PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2011
Last Update Date: 12/20/2022
Certification Date: 12/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2560 W GOLF RD
HOFFMAN ESTATES IL
60169-1114
US

IV. Provider business mailing address

2560 W GOLF RD
HOFFMAN ESTATES IL
60169-1114
US

V. Phone/Fax

Practice location:
  • Phone: 847-843-0440
  • Fax: 847-843-1142
Mailing address:
  • Phone: 847-843-0440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051.292718
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: