Provider Demographics
NPI:1215200456
Name:DALSANIA, DHARMESHKUMAR (RPH)
Entity Type:Individual
Prefix:MR
First Name:DHARMESHKUMAR
Middle Name:
Last Name:DALSANIA
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 1:314 W ARMY TRAIL RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-2300
Mailing Address - Country:US
Mailing Address - Phone:630-893-5382
Mailing Address - Fax:
Practice Address - Street 1:314 W ARMY TRAIL RD
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-2300
Practice Address - Country:US
Practice Address - Phone:630-893-5382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH026502183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist