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General NPI Number Information
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NPI Number | 1104258920
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Entity Type | Individual
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Provider Name | BHARAT ACHARYA
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Gender | Male
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Dates
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Enumeration Date | 08/02/2013
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Last Update Date | 08/02/2013
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Provider Practice Location Address
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Address Line | 7050 S PULASKI RD
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City | CHICAGO
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State | IL
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Zip | 60629-5824
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Country | US
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Telephone | 773-767-2807
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Fax | 773-767-9818
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Provider Business Mailing Address
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Address Line | 5 SHENANDOAH CT
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City | BOLINGBROOK
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State | IL
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Zip | 60440-1462
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Country | US
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Telephone |
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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 | 051031241
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License Number State | IL
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