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General NPI Number Information
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NPI Number | 1619696697
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Entity Type | Individual
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Provider Name | SARABBIR SINGH THIARA PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/24/2022
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Last Update Date | 08/24/2022
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Provider Practice Location Address
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Address Line | 2855 95TH ST
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City | NAPERVILLE
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State | IL
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Zip | 60564-9011
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Country | US
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Telephone | 630-904-7709
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Fax |
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Provider Business Mailing Address
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Address Line | 2575 ELDORADO LN
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City | NAPERVILLE
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State | IL
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Zip | 60564-8408
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Country | US
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Telephone | 630-506-2033
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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 | 051.304856
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License Number State | IL
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