Provider Demographics
NPI:1326727363
Name:CONTRACTOR, CHIRAGKUMAR PRAVINBHAI
Entity Type:Individual
Prefix:
First Name:CHIRAGKUMAR
Middle Name:PRAVINBHAI
Last Name:CONTRACTOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1489 PALATINE RD
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60192-1196
Mailing Address - Country:US
Mailing Address - Phone:847-202-9232
Mailing Address - Fax:
Practice Address - Street 1:1489 PALATINE RD
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60192-1196
Practice Address - Country:US
Practice Address - Phone:847-202-9232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.305499183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist