MEDICARE: VINAY SONI PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	051297940	IL

General Provider Information

NPI Number	:	1154921211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VINAY SONI PHARM.D.

Provider Business Mailing Address
First Line	:	4224 N PROSPECT DR
Second Line	:
City	:	DECATUR
State	:	IL
Zip	:	62526-6100
Country	:	US
Telephone Number	:	217-875-0190
Fax Number	:	217-875-0186

Provider Business Practice Location Address
First Line	:	4224 N PROSPECT DR
Second Line	:
City	:	DECATUR
State	:	IL
Zip	:	62526-6100
Country	:	US
Telephone Number	:	217-875-0190
Fax Number	:	217-875-0186

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/28/2020
Last Update Date	:	10/28/2020

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Directions to “ VINAY SONI PHARM.D.” Practice Location

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