Healthcare Provider Details

I. General information

NPI: 1093933921
Provider Name (Legal Business Name): NABEELA SAFDAR GILL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12850 STATE ROAD 23
GRANGER IN
46530-7183
US

IV. Provider business mailing address

12850 STATE ROAD 23
GRANGER IN
46530-7183
US

V. Phone/Fax

Practice location:
  • Phone: 574-807-8234
  • Fax: 866-420-2185
Mailing address:
  • Phone: 574-807-8234
  • Fax: 866-420-2185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26023449A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051286420
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: