Individual
SOHAM DEWASHRAYEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4201 W VICTORIA ST, CHICAGO, IL 60646-6700
(224) 601-4868
Mailing address
4201 W VICTORIA ST, CHICAGO, IL 60646-6700
(224) 601-4868
Taxonomy
Speciality
Code
Description
License number
State
1835G0303X
Geriatric Pharmacist
Primary
051289860
IL
Other
Enumeration date
02/11/2021
Last updated
02/11/2021
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