Provider Demographics
NPI:1033713250
Name:SUKUL, ILINA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ILINA
Middle Name:
Last Name:SUKUL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 E CHESTNUT ST APT 508
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-2766
Mailing Address - Country:US
Mailing Address - Phone:614-795-4280
Mailing Address - Fax:
Practice Address - Street 1:2160 N HIGH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43201-1113
Practice Address - Country:US
Practice Address - Phone:614-294-2105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-29
Last Update Date:2020-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03127506183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist