Provider Demographics
NPI:1073227112
Name:POWER, SARA JASMINA EFTEKHARI (PHARMD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:JASMINA EFTEKHARI
Last Name:POWER
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 1:1770 N MILWAUKEE AVE
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-1317
Mailing Address - Country:US
Mailing Address - Phone:847-327-9706
Mailing Address - Fax:847-327-9710
Practice Address - Street 1:1770 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-1317
Practice Address - Country:US
Practice Address - Phone:847-327-9706
Practice Address - Fax:847-327-9710
Is Sole Proprietor?:No
Enumeration Date:2023-01-12
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.305323183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist