Provider Demographics
NPI:1235584889
Name:PURATHUR, SAJITHA
Entity Type:Individual
Prefix:DR
First Name:SAJITHA
Middle Name:
Last Name:PURATHUR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 E SCHILLER ST
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-2869
Mailing Address - Country:US
Mailing Address - Phone:630-834-9122
Mailing Address - Fax:630-279-3218
Practice Address - Street 1:153 E SCHILLER ST
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-2869
Practice Address - Country:US
Practice Address - Phone:630-834-9122
Practice Address - Fax:630-279-3218
Is Sole Proprietor?:No
Enumeration Date:2016-05-02
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051293637183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist