Provider Demographics
NPI:1629526421
Name:ZHANG, CHI (PHARM D)
Entity Type:Individual
Prefix:
First Name:CHI
Middle Name:
Last Name:ZHANG
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8628 BLUE RIVER RD
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-5304
Mailing Address - Country:US
Mailing Address - Phone:469-396-2614
Mailing Address - Fax:
Practice Address - Street 1:8628 BLUE RIVER RD
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-5304
Practice Address - Country:US
Practice Address - Phone:469-396-2614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-21
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051299942183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist