Individual
DR. PRIYATMA WIRTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
5000 S 5TH AVE, BUILDING 217, ROOM 2B7, HINES, IL 60141-3030
(708) 202-2134
Mailing address
214 NORTHWOOD RD, RIVERSIDE, IL 60546-1834
(815) 275-5519
Taxonomy
Speciality
Code
Description
License number
State
1835G0303X
Geriatric Pharmacist
Primary
051292065
IL
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
051292065
IL
Other
Enumeration date
08/05/2008
Last updated
11/07/2023
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