Individual
KANTI CHAUDHARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12625 WESTERN AVE, BLUE ISLAND, IL 60406-1724
(708) 388-1200
Mailing address
12625 WESTERN AVE, BLUE ISLAND, IL 60406-1724
(708) 388-1200
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051289016
IL
183500000X
Pharmacist
62855
CA
Other
Enumeration date
11/03/2011
Last updated
11/03/2011
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