Healthcare Provider Details

I. General information

NPI: 1821928425
Provider Name (Legal Business Name): PRIT GOR PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2026
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4440 W 95TH ST
OAK LAWN IL
60453-2600
US

IV. Provider business mailing address

2185 WATERFALL LN
HANOVER PARK IL
60133-6707
US

V. Phone/Fax

Practice location:
  • Phone: 331-980-8826
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2339340
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051307173
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: