Provider Demographics
NPI:1619097235
Name:KSHATRIYA, SONALI G (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SONALI
Middle Name:G
Last Name:KSHATRIYA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 S ABERDEEN ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-2543
Mailing Address - Country:US
Mailing Address - Phone:630-891-5142
Mailing Address - Fax:
Practice Address - Street 1:1340 S CANAL ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-5208
Practice Address - Country:US
Practice Address - Phone:312-850-0398
Practice Address - Fax:312-850-9885
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist