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General NPI Number Information
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NPI Number | 1083082143
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Entity Type | Individual
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Provider Name | NISHANT BIPIN THAKKAR PHARM.D
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Gender | Male
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Dates
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Enumeration Date | 09/07/2015
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Last Update Date | 09/07/2015
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Provider Practice Location Address
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Address Line | 1347 HUNTER DR
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City | BARTLETT
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State | IL
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Zip | 60103-1828
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Country | US
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Telephone | 909-342-0917
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Fax |
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Provider Business Mailing Address
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Address Line | 1347 HUNTER DR
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City | BARTLETT
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State | IL
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Zip | 60103-1828
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Country | US
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Telephone | 909-342-0917
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 051.294737
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 62541
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License Number State | CA
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