Provider Demographics
NPI:1295460913
Name:OSHANA, ASHOR (PHARMD)
Entity Type:Individual
Prefix:
First Name:ASHOR
Middle Name:
Last Name:OSHANA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:695 BAXTER LN
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-1611
Mailing Address - Country:US
Mailing Address - Phone:312-479-0099
Mailing Address - Fax:
Practice Address - Street 1:2525 DUPONT DR
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-1599
Practice Address - Country:US
Practice Address - Phone:714-246-2658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051304750183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist