Provider Demographics
NPI:1023390085
Name:MANIAR, URVISH Y (RPH)
Entity Type:Individual
Prefix:MR
First Name:URVISH
Middle Name:Y
Last Name:MANIAR
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 MEACHAM RD
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60007-3073
Mailing Address - Country:US
Mailing Address - Phone:847-584-7082
Mailing Address - Fax:847-584-7087
Practice Address - Street 1:801 MEACHAM RD
Practice Address - Street 2:
Practice Address - City:ELK GROVE VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60007-3073
Practice Address - Country:US
Practice Address - Phone:847-584-7082
Practice Address - Fax:847-584-7087
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051288287183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist