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NPI Code Detail

MEDICARE: MR. AMBALAL HARJIVANDAS PATEL REG. PHARMACIST

MEDICARE: MR. AMBALAL HARJIVANDAS PATEL REG. PHARMACIST
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
1183500000XPharmacist051-032157IL

General Provider Information

NPI Number : 1811279631
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. AMBALAL HARJIVANDAS PATEL REG. PHARMACIST
Provider Business Mailing Address
First Line : 3110 W ARMITAGE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-3819
Country : US
Telephone Number : 773-235-6758
Fax Number : 773-235-1348
Provider Business Practice Location Address
First Line : 3110 W ARMITAGE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-3819
Country : US
Telephone Number : 773-235-6758
Fax Number : 773-235-1348
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2011
Last Update Date : 09/16/2011

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