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NPI Code Detail

MEDICARE: POOJA KUSHAL SHAH

MEDICARE: POOJA KUSHAL SHAH
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
1183500000XPharmacist051-303267IL

General Provider Information

NPI Number : 1346918885
Entity Type Code : Individual
Provider Name (Legal Business Name) : POOJA KUSHAL SHAH
Provider Business Mailing Address
First Line : 1285 S RAND RD
Second Line :
City : LAKE ZURICH
State : IL
Zip : 60047-2960
Country : US
Telephone Number : 847-438-8565
Fax Number :
Provider Business Practice Location Address
First Line : 1285 S RAND RD
Second Line :
City : LAKE ZURICH
State : IL
Zip : 60047-2960
Country : US
Telephone Number : 847-438-8565
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2021
Last Update Date : 08/31/2021

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Directions to “ POOJA KUSHAL SHAH ” Practice Location

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