Provider Demographics
NPI:1629734900
Name:TURSHAN, MUSTAFA
Entity Type:Individual
Prefix:DR
First Name:MUSTAFA
Middle Name:
Last Name:TURSHAN
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 1:8801 RIDGELAND AVE
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-1002
Mailing Address - Country:US
Mailing Address - Phone:708-599-6300
Mailing Address - Fax:
Practice Address - Street 1:8801 RIDGELAND AVE
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-1002
Practice Address - Country:US
Practice Address - Phone:708-599-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051304368183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist