Provider Demographics
NPI:1215212386
Name:BHAGAT, RINA (RPH, PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RINA
Middle Name:
Last Name:BHAGAT
Suffix:
Gender:F
Credentials:RPH, PHARMD
Other - Prefix:
Other - First Name:RINA
Other - Middle Name:
Other - Last Name:KACHHIAPATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH, PHARMD
Mailing Address - Street 1:300 S WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:ITASCA
Mailing Address - State:IL
Mailing Address - Zip Code:60143-2138
Mailing Address - Country:US
Mailing Address - Phone:847-612-7250
Mailing Address - Fax:
Practice Address - Street 1:641 MEACHAM RD
Practice Address - Street 2:
Practice Address - City:ELK GROVE VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60007-3047
Practice Address - Country:US
Practice Address - Phone:847-352-4061
Practice Address - Fax:847-352-4086
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051287167183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
256423OtherNABP-ID