Individual
AJANTA DAYAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
52482 INDIANA STATE ROUTE 933, SOUTH BEND, IN 46637-3852
(574) 271-0357
Mailing address
PO BOX 7192, BUFFALO GROVE, IL 60089-7192
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26028630A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
26028630A
—
IN
Enumeration date
02/07/2021
Last updated
02/07/2021
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