Individual
MR. FAZAL M PUTHAWALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D
Contact information
Practice address
7510 N WESTERN AVE, CHICAGO, IL 60645-1511
(773) 764-1765
(773) 764-9020
Mailing address
7510 N WESTERN AVE, CHICAGO, IL 60645-1511
(773) 764-1765
(773) 764-9020
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051-288930
IL
Other
Enumeration date
09/16/2011
Last updated
09/16/2011
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