Provider Demographics
NPI:1558480905
Name:SHAH, PINANK PRAKASHBHAI
Entity Type:Individual
Prefix:
First Name:PINANK
Middle Name:PRAKASHBHAI
Last Name:SHAH
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 1:2147 SILVER LINDEN LN
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-6631
Mailing Address - Country:US
Mailing Address - Phone:404-992-3764
Mailing Address - Fax:
Practice Address - Street 1:3147 W CERMAK RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60623-3307
Practice Address - Country:US
Practice Address - Phone:773-521-7422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH022832183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist