MEDICARE: MR. JIGNESH GANDHI

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	183500000X	Pharmacist	51-286602	IL

General Provider Information

NPI Number	:	1871588558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JIGNESH GANDHI

Provider Business Mailing Address
First Line	:	809 WILLIAMSTOWN DR
Second Line	:
City	:	CAROL STREAM
State	:	IL
Zip	:	60188-4746
Country	:	US
Telephone Number	:	630-653-3120
Fax Number	:	630-653-3120

Provider Business Practice Location Address
First Line	:	1400 E GOLF RD
Second Line	:	SUITE 101
City	:	DES PLAINES
State	:	IL
Zip	:	60016-1236
Country	:	US
Telephone Number	:	847-296-1400
Fax Number	:	847-296-1431

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

Provider Enumeration Date	:	09/19/2005
Last Update Date	:	07/08/2007

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